Title: Walking Epidural: Levobupivacaine versus Ropivacaine
Authors: Sarita Patnaik, Malaya Kumar Patel, Sumati Kandi, Shivnarayan Pattanaik, Sushree Satpathy
DOI: https://dx.doi.org/10.18535/jmscr/v8i7.71
Abstract
Background and Aims: Lumbar epidural analgesia is the gold standard technique for labour analgesia. This study was designed to evaluate the efficacy of local anaesthetics (0.1% levobupivacaine and 0.1% ropivacaine) with fentanyl 2µg/ml (quality of analgesia, motor blockade & duration of labour along with maternal satisfaction and foetal outcome) in epidural labour analgesia by intermittent bolus technique.
Material & Method: In this prospective, randomized, double blinded study, 60 primigravida were randomly assigned into two equal groups. Group A received 15ml 0.1% ropivacaine with 2µg/ml fentanyl and Group B received 15ml 0.1% levobupivacaine with 2µg/ml fentanyl. The onset, peak duration of analgesia, duration of labour and motor blockade was noted as primary outcome. Demographic profile, maternal satisfaction, mode of delivery and neonatal outcome were noted as secondary outcome.
Result: Levobupivacaine-fentanyl provided faster onset of analgesia, prolonged duration of action and reduced duration of labour with satisfactory maternal and foetal outcomes. However, ropivacaine-fentanyl provided better ambulation in parturients.
Conclusion: Low dose local anesthetics when used with the short acting opioids like fentanyl provide excellent maternal satisfaction, lesser or no motor blockade and good neonatal outcome.
Keywords: Epidural analgesia, levobupivacaine, ropivacaine, fentanyl.
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