B. Kanchanamala, S. Devasena
BACKGROUND Epidural neuraxial blockade is an efficient and an easy method of administering labour analgesia without any adverse effects on the foetus. Labour analgesia thus helps the mother enjoy the delivery of her child without pain or stress enhancing patient satisfaction. Bupivacaine was the routinely used local anaesthetic for labour analgesia. Bupivacaine combined with low dose of opioid was used to reduce the concentration of bupivacaine without compromising on quality of analgesia produced and also reducing the extent of motor blockade. But even with lowering the concentration of bupivacaine used and the addition of opioids, patient had minimal motor blockade which prevented them from being ambulant. Ropivacaine has helped us to provide ambulatory analgesia by overcoming the motor blockade without compromising on the quality of analgesia. The objective of this study was to compare analgesic efficacy, onset, duration of action, total dose of anaesthetic required, intensity of motor blockade and haemodynamic stability in patients admitted for safe confinement. MATERIALS AND METHODS 100 ASA physical status I & II parturients, aged 20-40 years, with normal to high BMI scheduled for safe confinement were included in the study. Patients were randomly allocated into two groups Group B (n = 50) & Group R (n = 50). Epidural technique was standardised. Efficacy of 0.1% bupivacaine with 2 mcg/ml fentanyl was compared with 0.1% ropivacaine with 2 mcg/ml fentanyl for labour analgesia. RESULTS The onset of analgesia as well as motor blockade was faster with bupivacaine when compared to ropivacaine. The total volume of local anaesthetic required was higher and the level of motor blockade produced was minimal with ropivacaine when compared to bupivacaine. There was no undue prolongation in duration of labour and the incidence of instrumental delivery were comparable between the groups. The patient satisfaction score, APGAR SCORE, demographic and haemodynamic parameters were comparable between the groups. CONCLUSION Administration of 0.1% Ropivacaine with 2 mcg/ml fentanyl provides minimal motor blockade when compared to 0.1% bupivacaine with 2 mcg/ml fentanyl.
