COMPARATIVE STUDY OF 0.0625% BUPIVACAINE WITH FENTANYL VERSUS 0.1% ROPIVACAINE WITH FENTANYL AS CONTINUOUS EPIDURAL INFUSION IN LABOUR ANALGESIA

BACKGROUND We undertook this study to see whether ropivacaine offers any significant advantage over bupivacaine in our institutional practice with regards to obstetrical outcome and whether a changeover from bupivacaine to ropivacaine was warranted. This study compares the efficacy of Ropivacaine and Bupivacaine regarding pain relief, motor block and labour characteristics. AIM The objective of the current study is to compare the efficacy of equipotent doses of ropivacaine with fentanyl and bupivacaine with fentanyl as continuous infusion in labour epidural analgesia with respect to Quality of pain relief, Motor Block, Duration of labour, Mode of delivery - Spontaneous Vaginal/Assisted with forceps/Caesarean Section, Neonatal outcome - APGAR score, Complications if any. METHODS AND MATERIALS The study was a prospective randomized double blinded trial involving 60 parturients (30 in each group) attending the Dept. of Obstetrics and Gynaecology, Chengalpattu Medical College Hospital. Informed consent was obtained. Detailed history of the patient was collected. Routine investigations were done as per our hospital labour protocol. Patients fulfilling the inclusion criteria and who gave consent were then randomly allocated to one of the study groups on the basis of computerized randomized list. STATISTICAL ANALYSIS The statistical analysis was done using SPSS version 16 for windows. The profiles of the cases were compared with the treatment allocation in order to check if there was any significant difference. Chi-square test for association was used to compare categorical variables between treatment allocations. RESULTS The observations of this study show that pain relief offered by epidural ropivacaine is as good and effective as epidural bupivacaine. Also the duration of labour, mode of delivery, neonatal outcome and complications are comparable between the two groups. CONCLUSION Findings suggest that the use of epidural ropivacaine for labour analgesia had no added advantage, because highly diluted concentrations of bupivacaine plus opioids reduce the risk of cardiovascular toxicity and the degree of motor block are equally effective as ropivacaine in the concentrations used in our study, and are less expensive and easily available.