Background and Aims:This study aims to compare the minimum effective concentration of local anesthetic (LA) bupivacaine and ropivacaine with highly lipid soluble opioids fentanyl for providing optimal labor epidural analgesia.Settings and Design:The objective of this study was to evaluate the efficacy of racemic bupivacaine 0.0625% and 0.1% of ropivacaine both mixed with 2 μg/ml of fentanyl for epidural labor analgesia in parturients with spontaneous labor and normal fetal heart rate tracing.Methodology:Sixty parturients requesting for labor analgesia were divided into two groups. Group B (n = 30) received racemic bupivacaine (0.0625%) and fentanyl 2 μg/ml of 10 ml and Group R (n = 30) received ropivacaine (0.1%) and fentanyl 2 μg/ml. In both groups, the drug was given in 5 ml fractionated doses at 5 min interval. Parturients not experiencing analgesia within 15 min of initial bolus were supplemented with additional 5 ml of the same concentration of the solution. Epidural analgesia was maintained by timed top ups at the end of 90 min with the dosage equal to the initial dose of the drug. Duration of labor analgesia, motor block, visual analog scale, maternal hemodynamic parameters, mode of delivery, and maternal satisfaction was assessed.Statistical Analysis:Data were analyzed with odds variance, unpaired t-test, and Chi-square tests. P < 0.05 was considered statistically significant.Results:In our study, results indicate that both drugs were equally effective clinically. Maternal demographic characteristics were comparable. There were no statistically significant differences in visual analog pain score, highest sensory block, maternal satisfaction, mode of delivery, total dose of LAs during labor and motor block at delivery between the groups.Conclusions:In our study, both the drugs produced equivalent analgesia for labor at low concentration when used with highly lipid soluble opioid such as fentanyl.

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Background: The study was to compare the sensory and motor blockade characteristics and duration of postoperative analgesia between Nalbuphine and Fentanyl as an adjunct to intrathecal Bupivacaine in spinal anaesthesia. Settings and design: To compare the clinical efficacy of hyperbaric Bupivacaine with Fentanyl and hyperbaric Bupivacaine with Nalbuphine with reference to onset and duration of sensory block, onset and duration of motor block, duration of post op analgesia, hemodynamic stability, level of sedation and complications. Methodology: 60 female patients of 30-55 years of age with ASA Ι, II undergoing elective trans-abdominal hysterectomy under spinal anaesthesia were randomly allocated to two groups. Group BUF -0.5ml (25µg) Fentanyl and Group BUN -0.5 ml (1 mg) Nalbuphine, with 3ml of 0.5% hyperbaric Bupivacaine. Onset and duration of sensory block, duration of post op analgesia, hemodynamic stability, level of sedation and complications were assessed. Statistical analysis: Data were analysed using Student t test and Chi-square test for parameters on continuous scale and categorical scale respectively p value < 0.05 was considered significant. Results: Though onset of sensory and motor block was faster in BUF, the BUN group had prolonged post op analgesia. Mean VAPS reduction at 24hr in BUN (3.26+/-0.541) compared to BUF (2.78+/-0.585) was statistically significant with p value 0.0016(<0.05). No statistical significance was seen with respect to hemodynamic stability and duration of motor block. Conclusion: Nalbuphine, an agonist-antagonist is a good adjuvant to intrathecal Bupivacaine, providing intense and prolonged postoperative analgesia without any significant adverse effects.