Context: Better obstetric outcome is produced when ropivacaine is used for labour as compared to bupivacaine. Several studies insist on use of these drugs along with opioids. Aims: The following study compares bupivacaine and ropivacaine without opioids for labour epidural analgesia. Settings and Design: This prospective comparative study was conducted at a tertiary care hospital in central India. Methods and Material: A total of 60 parturient were randomly allocated into two groups to receive labour epidural analgesia with 10 ml each of 0.125%bupivacaine or 0.2%ropivacaine as main dose. A sensory level block of T10-L1 in the first stage of labour and a level of T10-S4 was achieved during 2nd stage of labour. A top up dose of 5ml 0.125%bupivacaine or 5ml 0.2%ropivacaine were given to the two groups respectively to patients complaining of pain. Labour was managed according to institutional standard labour protocols. Statistical analysis used: The data was collected using Microsoft Excel software and was analysed using SPSS software version17.0. Results: The onset was faster in bupivacaine group (mean 16.17 ± 2.214 min) as compared with ropivacaine group (mean 22.07 ± 3.039 min). The duration of analgesia was prolonged in ropivacaine group (mean 182.83 ±41.37 min.) as compared to bupivacaine group (mean 161.33 ±3.25min), number of top ups given in bupivacaine group were higher. However there was no difference in any other obstetric or neonatal outcomes. Conclusions: 0.2%ropivacaine is better for labour analgesia suggested by superior quality and intensity of analgesia according to Visual Analog Scale; less requirement of top ups; better maternal satisfaction.
Keywords: bupivacaine, ropivacaine, labour analgesia, opioidKey Messages: A comparison of bupivacaine and ropivacaine without opiods for labour epidural analgesia.