Abstract

Background: Pain relief in labour has always been surrounded with myths and controversies. Hence providing effective and safe analgesia during labour has remain an ongoing challenge. This study was undertaken to compare fentanyl and clonidine with ropivacaine in epidural labour analgesia.

Methods: A total of 60 term parturients with uncomplicated pregnancy, vertex presentation, posted for on-demand epidural labour analgesia were divided into two groups. Group RF (n=30) patients received 10ml solution comprising 0.1% ropivacaine with fentanyl 20mcg. Group RC (n=30) patients received 10ml of 0.1% ropivacaine with clonidine 60mcg. Characteristics of the block, onset and duration of analgesia and total analgesic requirements were noted. Pain and overall satisfaction scores were assessed with a 10-point visual analogue scale. Mode of delivery and neonatal APGAR scores were recorded.

Result: At baseline, groups were matched demographically, haemodynamically as well as for intensity of pain. A significant difference among groups in VAS was observed from 120min intervals and lowest values were in group RC. No significant difference was observed in haemodynamic parameters, mode of delivery and expulsive efforts. Total analgesic dose and top up dose requirement was more in group RF. Six percent of patients in group RF and 10 percent of patients in group RC developed nausea.

Conclusion: Ropivacaine 0.1% was effective in decreasing labour pain without any motor blockade. Clonidine was superior to fentanyl as an adjuvant in labour without any significant feto-maternal adverse effects.

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