Introduction and Aim: Ropivacaine and bupivacaine have been found to provide adequate labor analgesia when given epidurally. The aim of this randomized double blind study was to compare the onset of sensory block in epidural ropivacaine and bupivacaine with Fentanyl for labor analgesia and to assess the maternal and fetal outcome. Materials and Methods: In this prospective double blind study, 60 ASA II parturients with singleton vertex presentation were randomly allocated to two groups of 30 each. Group R received 5 ml 0.2% ropivacaine with 50mcg Fentanyl as bolus, followed by continuous infusion of ropivacaine 0.1% with Fentanyl 1 mcg/ml at 6 ml/hr. Group B received 5 ml 0.125% bupivacaine with 50 mcg Fentanyl as bolus, followed by continuous infusion of bupivacaine 0.0625% with Fentanyl 1 mcg/ml at 6 ml/hr. Onset and regression of sensory level, degree of motor block, hemodynamic effects, mode of delivery, neonatal outcome and patient satisfaction were compared. The statistical analysis was done using the Mean, Standard Deviation and the student 't' test. Results: There was a significantly faster onset of sensory block with ropivacaine (5.67±0.99min) compared to bupivacaine (6.67±1.39min) (p <0.05). There were no significant differences between the groups regarding the duration, quality of analgesia, degree of motor block, hemodynamic parameters, mode of delivery, neonatal safety and patient acceptability. Conclusion: Ropivacaine provides effective analgesia with faster onset of sensory block in comparison to bupivacaine and is safe for mother and fetus.

BACKGROUND: Neuraxial labor analgesia might prolong, shorten or not alter the first stage of labor. Prolongation can have deleterious effects on the progress of labor and mode of delivery which can be undesirable for the parturient and neonate. No randomized controlled trial has investigated the duration of first stage of labor as a primary outcome, with epidural analgesia compared to systemic analgesia. Methods: 500American Society of Anesthesiologists (ASA) physical status I primigravidae, aged 18-35 years, gestational age>37 weeks with singleton cephalic presentation were divided into study (epidural) and control (systemic analgesia) groups. The systemic group received tramadol 2mg/kg and phenergan 0.5mg/kg intramuscularly sixth hourly. The study group received 10ml 0.1% Ropivacaine with 50mcg Fentanyl bolus. 0.1% Ropivacaine with Fentanyl 0.0001% was given as infusion at 5ml/hr. For break through pain and at full cervical dilatation, 5ml bolus of the drug was given. The first stage was from active phase of labor to full cervical dilatation (10cm). Maternal& neonatal outcome and analgesia were monitored. Results: 203 parturients in the study group and 208 in the control group completed the study. First stage was significantly prolonged in the study group compared to the control group (367.39±76.72min v/s 308.22±89.31min, p value=0.000, 95% CI= (-75.33, -43.00)). The safety of mother and neonate was ensured. Quality of analgesia was excellent or good in 70% of the parturients in study group and 25% in the control group. Conclusion: Epidural analgesia compared to systemic analgesia, prolongs the first stage of labor, but is not associated with adverse maternal or neonatal outcome.

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