Abstract
Introduction: Epidural infusion of 0.2% ropivacaine is recommended by the manufacturer for labour analgesia, but lower concentrations may be effective. The present work is a clinical comparative study of different doses of ropivacaine i.e. 0.05%, 0.1% and 0.2%, each with 2 mcg/mL of fentanyl to find out minimum effective concentration of ropivacaine that can be used safely in epidural labor analgesia.
Materials and Methods: The study was conducted on sixty (60) parturient of ASA grade I and grade II physical status, in labor, with single fetus, vertex position, between 37-42 weeks gestation with regular contractions (true labor pain) with 4-6 cm cervix dilatation and who had requested labor analgesia. Parturients were then allocated randomly to one of three groups with 20parturients in each group. Group 1 received 0.05% ropivacaine with 2 mcg/mL fentanyl, Group 2 received 0.1% ropivacaine with2 mcg/mL fentanyl and Group 3 received 0.2% ropivacaine with 2 mcg/mL fentanyl. After completion of the study, the nonparametric data of the study was analyzed with Kruskal Wallis test and parametric data of the study was analyzed with ANOVA test and p value of <0.05 was taken as statistically significant.
Results: Patient demographics and labor characteristics were comparable in all the groups. Ropivacaine 0.05% with 2 mcg/mL of fentanyl produced adequate analgesia for labor and delivery in only 50% of parturient while ropivacaine 0.1% &ropivacaine0.2% with 2 mcg/mL of fentanyl produced adequate analgesia in 90% of parturient in group II and group III. Reduction in local anesthetic was not associated with any change in incidence of motor block or instrumental deliveries.
Conclusion: We concluded that the minimum concentration which can be used safely for labor analgesia with no adverse effect is 0.1% of ropivacaine with 2 mcg/mL fentanyl.
Keywords: epidural labour analgesia, Ropivacine, fentanyl.
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Corresponding Author
Dr Tushar Majumder
Senior Resident, Dept. of Anesthesiology, AGMC and GBP hospital, Agartala
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.06
