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Indian Journal of Anesthesia and Analgesia

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Comparative Study between Ropivacaine 0.2% Versus Bupivacaine 0.2% in Epidural Labor Analgesia

Annasaheb Maske, Assistant Professor, Department of Anesthesiology, JIIU‘s IIMSR Medical College and Hospital, Warudi, Jalna-431202, Maharastra, India. , Annasaheb Maske1 , Ashok Deshmukh1 , Arvindanand Rajgure2

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Indian Journal of Anesthesia and Analgesia 4(3):p 735-739, July - September 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.30

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Abstract

Introduction: The epidural analgesia is popular and effective method of labour analgesia since the parturient remains awake, pain free and comfortable, watches her delivery and immediately can feed her baby. Bupivacaine is causes cardio toxicity and the discomfort due to motor blockade that limits its use. Motor blockade reduces her mobility and increase the chances of assisted deliveries. Ropivacaine induces less lower extremity motor blockade and has a lower potential for cardiovascular and central nervous system toxicity. Material and Methods: A total of 90 patients were included in the study, of which 45 patients were randomly allocated to each one of the ropivacaine or bupivacaine group. In ropivacaine group patient Inj. Ropivacaine 0.2% vol. 8 to 10 ml and in Bupivacaine group Inj. Bupivacaine 0.2% 8 to 10 ml a bolus dose was given. Adequate analgesia visual analogue scale [VAS] of 3 was considered as an endpoint. Intermittent bolus doses were given of 50% of initial bolus dose on SOS basis which was on an average 1 to 1.5 hrs after initial dose. Vital parameters, VAS score, motor block was noted. Results: The VAS score in Ropivacaine 0.2% group was excellent i.e. 0 to 3 in 38 (84.4%) patients , out of which 26 patients were absolutely pain free after 15 mins of the bolus dose. Among the Bupivacaine group excellent score AVS < 3 was found in 29 (64.5%) patients. 18 parturients (40%) in the Bupivacaine group and 35 (77.8%) in the Ropivacaine group did not show any motor block (Bromage=0) throughout labour. The study showed that 21 (46.7%) patients of Bupivacaine group and 25 (55.5%) patients of ropivacaine group delivered spontaneous vaginal delivery and 18 (40%) patients of Bupivacaine group and 13(28.8%) patients of ropivacaine group delivered with instrumental vaginal delivery. There was no significant difference in the outcome or the mode of delivery in both the groups. The delivery time was shortened in both the groups. Conclusion: It can be concluded that both the drugs are effective in producing labor analgesia. Ropivacaine group parturients; had a faster onset and significantly longer duration of analgesia with a single dose and required lesser top-ups and there was less motor blockade.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4317.30

Keywords

Epidural; Ropivacaine; Bupivacaine; Labour Analgesia; Motor Block.

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