A comparison of continuous infusion and intermittent bolus administration of 0.1% ropivacaine with 0.0002% fentanyl for epidural labor analgesia

Patkar, Chinmayi Surendra; Vora, Kalpana S; Patel, Hiral R.; Shah, Veena R; Modi, Manisha P; Parikh, Geeta P

doi:10.4103/0970-9185.155155

Cited by 27 publications

(16 citation statements)

References 18 publications

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“…and Patkar et al . [513] The rise in heart rate among parturients as observed in our study was attributed to administration of intravenous injection valethamate bromide for enhancing the dilatation of cervix. [17]…”

Section: Discussionmentioning

confidence: 58%

Quality of labor epidural analgesia and maternal outcome with levobupivacaine and ropivacaine: A double-blinded randomized trial

et al. 2017

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Background:Quality of labor analgesia plays a vital role in the maternal outcome. Very few literature are available analyzing the quality of epidural labor analgesia.Aim:The aim of this study was to compare the effectiveness of 0.1% levobupivacaine and 0.1% ropivacaine with fentanyl as an adjuvant for epidural labor analgesia in terms of onset, duration, quality of analgesia, and degree of motor blockade.Methodology:Sixty nulliparous parturients, with singleton uncomplicated pregnancy, were recruited by continuous sampling. Parturients were randomized to receive either levobupivacaine 0.1% or ropivacaine 0.1% with 2 μg/ml fentanyl as an intermittent epidural bolus. The epidural analgesia was initiated with 12 ml of study drug solution in the active stage of labor (cervix 3 cm dilated). Demand bolus was given whenever the visual analog scale (VAS) score >3. Onset, duration, and quality of analgesia and degree of motor blockade were analyzed. Maternal outcome was evaluated in terms of mode of delivery, duration of labor, and assisted vaginal delivery.Statistical Analysis:All the data were recorded in Microsoft Office Excel. Statistical analysis was carried out using SPSS version 19.0 (IBM SPSS, USA) software with Regression Modules installed. Descriptive analyses were reported as mean and standard deviation of continuous variables.Results:The mean onset of analgesia was shorter in ropivacaine (21.43 ± 2 min) than in levobupivacaine group (23.57 ± 1.71 min) (P = 0.000). Duration of analgesia was shorter in ropivacaine (60 ± 14 min) than levobupivacaine (68 ± 11 min) (P = 0.027). Levobupivacaine produced a better quality of analgesia in terms of not perceiving pain and uterine contraction during labor analgesia but was associated with 37% incidence of instrumental delivery. Duration of labor and rate of cesarean section were comparable between the groups.Conclusion:Quality of analgesia in labor epidural was superior to levobupivacaine but was associated with higher incidence of instrumental vaginal delivery.

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Section: Discussionmentioning

confidence: 58%

Quality of labor epidural analgesia and maternal outcome with levobupivacaine and ropivacaine: A double-blinded randomized trial

et al. 2017

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“…Ropivacaine has a high threshold for cardiovascular toxicity, and it has been reported that low concentration of ropivacaine is extremely safe and effective for labor delivery analgesia [26,27] . Compared with continuous infusion, intermittent bolus administration of mixed drug of ropivacaine 0.1% with fentanyl 0.0002% provides a more efficacious route of drug delivery without adversely affecting maternal safety or satisfaction [28] . Our clinical trial demonstrated that the NA proposed by NPLD project was effective.…”

Section: Discussionmentioning

confidence: 99%

The initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective studyThe initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective study

Zhao¹,

Gao²,

Sun³

et al. 2020

Preprint

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Background No Pain Labor ＆Delivery (NPLD) is a nongovernmental project to increase access to safe neuraxial analgesia through specialized training. This study explores the change is overall cesarean delivery (CD) and maternal request CD(MRCD) rate in our hospital after the initiation of neuraxial analgesia service. Methods The neuraxial labor analgesia（NA） was initiated in May 1st 2015 by the help of NPLD. Since then, the application of NA became a routine operation in our hospital, and every parturient can choose to use NA or not according to her own requirement. The monthly rates of NA, CD, MRCD, multiparous women, intrapartum CD, episiotomy, postpartum hemorrhage (PPH), operative vaginal delivery and neonatal asphyxia of vaginal delivery were analyzed from May 1st 2015 to April 30th 2016. Results The rate of NA in our hospital was getting increasingly higher from 26.1% in May 2015 to 44.6% in April 2016 (p<0.001); the rate of CD was decreased from 50.4% in May 2015 to 36.3% in April 2016 ( p<0.001); the rate of MRCD was decreased from 10.8% in May 2015 to 5.7% in April 2016 (p<0.001), but the rate of multiparous women had no change (p＞0.05). There was a negative correlation between the rate of NA and that of overall CD, r=-0.803 (95%CI[-0.951, -0.642], p=0.002), and also a negative correlation between the utilization rate of NA and that of MRCD, r=-0.790 (95%CI[-0.971, -0.497], p=0.004). The rates of episiotomy, PPH, operative vaginal delivery and neonatal asphyxia in women underwent vaginal delivery as well as the rates of intrapartum CD, neonatal asphyxia, and PPH in women underwent CD remained unchanged from May 1st 2015 to April 30th 2016. Conclusions: Our study shows that the rates of CD and MRCD in our department significantly were decreased over a year period (2015. 05.01~2016. 04.30), which may be due to the increasing use of NA during vaginal delivery by the help of NPLD. Key Words: Neuraxial Labor Analgesia; Cesarean Delivery; Maternal Request Cesarean Delivery

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“…A neuraxial approach is accepted as the gold standard for intrapartum labor analgesia [26,27] . The mixed drugs of ropivacaine and fentanyl administrated by PCEA pump is extremely safe and effective for labor delivery analgesia [26][27][28] . Our clinical trial demonstrated that the NA proposed by NPLD was effective, which reduced the delivery pain from average 9.2 to 3.1 according to VAS and NRS.…”

Section: Discussionmentioning

confidence: 99%

The effect of initiating neuraxial analgesia service on the rate of cesarean delivery in Hubei, China: A 16-month retrospective study

Zhao

GAO

Sun

et al. 2020

Preprint

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Background No Pain Labor ＆Delivery (NPLD) is a nongovernmental project to increase access to safe neuraxial analgesia through specialized training. This study explores the change in overall cesarean delivery (CD) rate and maternal request CD(MRCD) rate in our hospital after the initiation of neuraxial analgesia service. Methods A neuraxial labor analgesia（NA） was initiated in May 1st 2015 by the help of NPLD. Since then, the application of NA became a routine operation in our hospital, and every parturient can choose to use NA or not according to her own requirement. The monthly rates of NA, CD, MRCD, multiparous women, intrapartum CD, episiotomy, postpartum hemorrhage (PPH), operative vaginal delivery and neonatal asphyxia of vaginal delivery were analyzed from January 1st 2015 to April 30th 2016. Results The rate of NA in our hospital was getting increasingly higher from 26.1% in May 2015 to 44.6% in April 2016 ( p< 0.001); the rate of CD was decreased from 50.4% in May 2015 to 36.3% in April 2016 ( p< 0.001); the rate of MRCD was decreased from 10.8% in May 2015 to 5.7% in April 2016 ( p< 0.001); but the rates of overall CD and MRCD remained stable at a high level from January to May 2015( p ＞0.05). At the same time, the rate of multiparous women remained unchanged during the 16 month of observation ( p ＞0.05). There was a negative correlation between the rate of NA and rate of overall CD, r=-0.803 (95%CI[-0.951, -0.642], p =0.002), and between the utilization rate of NA and rate of MRCD, r=-0.790 (95%CI[-0.971, -0.497], p =0.004).The rates of episiotomy, PPH, operative vaginal delivery and neonatal asphyxia in women who underwent vaginal delivery as well as the rates of intrapartum CD, neonatal asphyxia, and PPH in women who underwent CD remained unchanged from January 1st 2015 to April 30th 2016 . Conclusions: Our study shows that the rates of CD and MRCD in our department were significantly decreased from January 1st 2015 to April 30th 2016, which may be due to the increasing use of NA during vaginal delivery.

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A comparison of continuous infusion and intermittent bolus administration of 0.1% ropivacaine with 0.0002% fentanyl for epidural labor analgesia

Cited by 27 publications

References 18 publications

Quality of labor epidural analgesia and maternal outcome with levobupivacaine and ropivacaine: A double-blinded randomized trial

Quality of labor epidural analgesia and maternal outcome with levobupivacaine and ropivacaine: A double-blinded randomized trial

The initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective studyThe initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective study

The effect of initiating neuraxial analgesia service on the rate of cesarean delivery in Hubei, China: A 16-month retrospective study

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