BACKGROUND: Several studies have been performed to find a safe method of labor analgesia with minimal side effects and toxicity in mother and fetus. We aimed to compare the efficacy and side effects of epidural bupivacaine plus fentanyl and ropivacaine plus fentanyl at low concentrations. METHOD:Forty ASA I-II parturients' were included in this prospective, double-blind, trial and randomized to receive either bupivacaine or ropivacaine for labor analgesia. Analgesia was initiated with 8 mL of 0.125% solution plus fentanyl 50 microg and maintained with a continuous infusion of 0.0625% solution with fentanyl 2 microg/mL. RESULTS: There were no differences in pain scores, total dose of local anesthetics used, sensory or motor blockade, labor duration, mode of delivery, side effects, patient satisfaction, or neonatal outcome between the two local anesthetics at these dosages, but at the end of the second stage and delivery, adequate analgesia quality could not be ensured. CONCLUSION: We found no major advantage of continuous epidural infusion of ropivacaine 0.0625% plus fentanyl 2 microg/mL over bupivacaine 0.0625% plus fentanyl 2 microg/mL for labor analgesia. We believe that different methods or dosages may be tried in order to improve comfort at the second stage of labor and the delivery.
RCT Entities:
BACKGROUND: Several studies have been performed to find a safe method of labor analgesia with minimal side effects and toxicity in mother and fetus. We aimed to compare the efficacy and side effects of epidural bupivacaine plus fentanyl and ropivacaine plus fentanyl at low concentrations. METHOD: Forty ASA I-II parturients' were included in this prospective, double-blind, trial and randomized to receive either bupivacaine or ropivacaine for labor analgesia. Analgesia was initiated with 8 mL of 0.125% solution plus fentanyl 50 microg and maintained with a continuous infusion of 0.0625% solution with fentanyl 2 microg/mL. RESULTS: There were no differences in pain scores, total dose of local anesthetics used, sensory or motor blockade, labor duration, mode of delivery, side effects, patient satisfaction, or neonatal outcome between the two local anesthetics at these dosages, but at the end of the second stage and delivery, adequate analgesia quality could not be ensured. CONCLUSION: We found no major advantage of continuous epidural infusion of ropivacaine 0.0625% plus fentanyl 2 microg/mL over bupivacaine 0.0625% plus fentanyl 2 microg/mL for labor analgesia. We believe that different methods or dosages may be tried in order to improve comfort at the second stage of labor and the delivery.
Authors: L M Taft; R S Evans; C R Shyu; M J Egger; N Chawla; J A Mitchell; S N Thornton; B Bray; M Varner Journal: J Biomed Inform Date: 2008-09-14 Impact factor: 6.317