Effects of intrapartum epidural analgesia at high altitudes: maternal, fetal, and neonatal outcomes. A randomized controlled trial of two formulations of analgesics

Shokry, Mahmoud; Manaa, Essam M.; Shoukry, Randa Ali; Shokeir, Mohamed Hossam; Elsedfy, Ghada O.; El-Aziz, A. A. Abd

doi:10.3109/00016349.2010.484042

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…There was a significantly faster onset of sensory block with ropivacaine compared to bupivacaine (5.67 min versus 6.67min, p = 0.0013). Shokry et al 7 compared 0.125% bupivacaine and 0.2% ropivacaine, each with Fentanyl 100 µg and found a faster onset of sensory block with ropivacaine like in our study. Contrary to our findings, Bawdane et al's 8 double blind comparison of 0.1% ropivacaine to 0.1% bupivacaine each with Fentanyl for labor analgesia showed that both the drugs were similar in respect to the onset of sensory blockade.…”

Section: Discussionsupporting

confidence: 75%

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

Rakhee¹,

Ipe²,

Abraham³

et al. 2020

IJCA

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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.

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Section: Discussionsupporting

confidence: 75%

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

Rakhee¹,

Ipe²,

Abraham³

et al. 2020

IJCA

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“…Shokry et al ( 18 ) compared two groups receiving 0.125% bupivacaine and 0.2% ropivacaine, each with fentanyl 100 µg and found an non-significant faster onset of action and significantly shorter duration of analgesia in the ropivacaine group. In contrast, Chora and Hussain ( 4 ) showed significantly faster onset of analgesia in the bupivacaine group and longer duration in the ropivacaine group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of bupivacaine and ropivacaine in combination with fentanyl used for walking epidural anesthesia in labor

Gündüz

Yalçın

Karakoç

et al. 2017

tjod

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Objective:Effective pain relief during labor is essential to reduce maternal and perinatal morbidity arising due to pain-induced maternal sympathetic activation, and to avoid unnecessary cesarean sections performed due to maternal anxiety. Walking epidural analgesia on labor reveals lower pain scores, leading to higher maternal satisfaction with better cardiovascular and pulmonary physiology. Despite the extensive use and relative safety of bupivacaine, newer drugs such as ropivacaine have been developed as alternative agents to decrease the risk for cardiac and central nervous system toxicity.Materials and Methods:One hundred women who requested epidural analgesia in active labor were randomly allocated into two groups; one group received 20 mL of ropivacaine 0.125% with fentanyl 50 µg and the other received 20 mL of bupivacaine 0.125% with fentanyl 50 µg. The efficacy of analgesia, adverse effects, and obstetric and neonatal outcomes of both groups were compared.Results:There were no differences between the two study groups in the measured obstetric and neonatal outcomes. The onset time, duration of analgesia, and sensory levels were similar between the groups. Visual analog pain scale scores did not differ between the groups before analgesia or at any of the subsequent evaluation periods.Conclusion:Both ropivacaine and bupivacaine provide equivalent labor analgesia with high maternal satisfaction and tolerable adverse effects in the clinically used dose range. No adverse obstetric or neonatal outcomes were observed in either group. Therefore, either drug is a reasonable choice for labor analgesia and can be used without jeopardizing the safety of the mother and fetus.

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Effects of intrapartum epidural analgesia at high altitudes: maternal, fetal, and neonatal outcomes. A randomized controlled trial of two formulations of analgesics

Abstract: At high altitudes, no major advantage was found for epidural ropivacaine over bupivacaine in addition to fentanyl for labor analgesia and no harmful effects of the medications were found on mothers, fetuses, or newborns.

Cited by 2 publications

References 29 publications

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

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

Comparison of bupivacaine and ropivacaine in combination with fentanyl used for walking epidural anesthesia in labor

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