A randomized controlled double blind study comparing the efficacy of epidural ropivacaine and bupivacaine with fentanyl for labor analgesia

Abstract

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.

Analgesic Effects, Birth Process, and Prognosis of Pregnant Women in Normal Labor by Epidural Analgesia Using Sufentanil in Combination with Ropivacaine: A Retrospective Cohort Study

“…Sufentanil has stronger analgesic effect and longer action time, so sufentanil has unique advantages in epidural labor analgesia. During intrathecal administration of sufentanil, it mainly acts on the opioid receptors on the surface of the spinal cord, and its analgesic effect is about 4/5 times higher compared to fentanyl [ 40 ]. The high placental transfer rate of sufentanil has raised concerns about the safety of sufentanil, but it has been reported that sufentanil is absorbed into the epidural space very little, so it has little effect on the fetus.…”