Labour Epidural Analgesia: A Randomised Double Blind Comparative Study of 0.1% Levobupivacaine with Fentanyl vs. 0.1% Ropivacaine with Fentanyl
Introduction: Levobupivacaine and ropivacaine are suitable alternatives to bupivacaine for labour analgesia as they produce less motor blockade, decreased incidence of instrumental deliveries and less toxicity. Aim: To study the efficacy of epidural levobupivacaine and ropivacaine in intermittent do...
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JCDR Research and Publications Private Limited
2018-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/11769/31764_CE[Ra1]_F(SL)_PF1(AJ_SL)_PFA(AJ_MJ_AP)_PB(AJ_SL)_PN(SL).pdf |
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| author | Debasmita Das Deepali Pankaj Thakur Bharati Anil Tendolkar |
| author_facet | Debasmita Das Deepali Pankaj Thakur Bharati Anil Tendolkar |
| author_sort | Debasmita Das |
| collection | DOAJ |
| description | Introduction: Levobupivacaine and ropivacaine are suitable alternatives to bupivacaine for labour analgesia as they produce less motor blockade, decreased incidence of instrumental deliveries and less toxicity. Aim: To study the efficacy of epidural levobupivacaine and ropivacaine in intermittent doses for labour analgesia. Materials and Methods: In the present prospective, randomised, double blind study, 60 parturients consenting for labour epidural analgesia using intermittent top-up technique were randomly allocated to receive either levobupivacaine 0.1% with Fentanyl 2 mcg/mL (LF) or ropivacaine 0.1% with Fentanyl 2 mcg/mL (RF). Haemodynamic parameters, sedation score, onset and quality of analgesia, sensory and motor blockade, local anaesthetic requirement, side effects, duration of labour, mode of delivery, neonatal outcome and maternal satisfaction were compared between groups. Statistical analysis included students unpaired t-test, chi-square test, Fischer’s-exact test, Mann-Whitney U-test as appropriate with p<0.05 was considered statistically significant. Results: Demographic and obstetric parameters were comparable in two groups. Both drugs were comparable with respect to haemodynamics, sedation score, onset and quality of analgesia, sensory and motor blockade, local anaesthetic requirement, duration of labour, mode of delivery, neonatal outcome, maternal satisfaction and side effects. One parturient (3.33%) in RF group developed motor block of Bromage grade 1 as compared to none in LF group without any statistical significance. No parturient required Rescue analgesia. Conclusion: The combinations of low concentration (0.1%) of epidural levobupivacaine and ropivacaine with fentanyl provide equivalent labour analgesia, without significant maternal or fetal side effects. |
| first_indexed | 2024-12-12T03:40:21Z |
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| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-12T03:40:21Z |
| publishDate | 2018-07-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-269072f54a1e4b1eaadad5a3202235b02022-12-22T00:39:42ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-07-01127UC06UC1010.7860/JCDR/2018/31764.11769Labour Epidural Analgesia: A Randomised Double Blind Comparative Study of 0.1% Levobupivacaine with Fentanyl vs. 0.1% Ropivacaine with FentanylDebasmita Das0Deepali Pankaj Thakur1Bharati Anil Tendolkar2Resident, Department of Anaesthesia, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.Associate Professor, Department of Anaesthesia, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.Professor and Head, Department of Anaesthesia, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.Introduction: Levobupivacaine and ropivacaine are suitable alternatives to bupivacaine for labour analgesia as they produce less motor blockade, decreased incidence of instrumental deliveries and less toxicity. Aim: To study the efficacy of epidural levobupivacaine and ropivacaine in intermittent doses for labour analgesia. Materials and Methods: In the present prospective, randomised, double blind study, 60 parturients consenting for labour epidural analgesia using intermittent top-up technique were randomly allocated to receive either levobupivacaine 0.1% with Fentanyl 2 mcg/mL (LF) or ropivacaine 0.1% with Fentanyl 2 mcg/mL (RF). Haemodynamic parameters, sedation score, onset and quality of analgesia, sensory and motor blockade, local anaesthetic requirement, side effects, duration of labour, mode of delivery, neonatal outcome and maternal satisfaction were compared between groups. Statistical analysis included students unpaired t-test, chi-square test, Fischer’s-exact test, Mann-Whitney U-test as appropriate with p<0.05 was considered statistically significant. Results: Demographic and obstetric parameters were comparable in two groups. Both drugs were comparable with respect to haemodynamics, sedation score, onset and quality of analgesia, sensory and motor blockade, local anaesthetic requirement, duration of labour, mode of delivery, neonatal outcome, maternal satisfaction and side effects. One parturient (3.33%) in RF group developed motor block of Bromage grade 1 as compared to none in LF group without any statistical significance. No parturient required Rescue analgesia. Conclusion: The combinations of low concentration (0.1%) of epidural levobupivacaine and ropivacaine with fentanyl provide equivalent labour analgesia, without significant maternal or fetal side effects.https://jcdr.net/articles/PDF/11769/31764_CE[Ra1]_F(SL)_PF1(AJ_SL)_PFA(AJ_MJ_AP)_PB(AJ_SL)_PN(SL).pdfanaesthetic drugslow concentration local anaestheticsopioids |
| spellingShingle | Debasmita Das Deepali Pankaj Thakur Bharati Anil Tendolkar Labour Epidural Analgesia: A Randomised Double Blind Comparative Study of 0.1% Levobupivacaine with Fentanyl vs. 0.1% Ropivacaine with Fentanyl Journal of Clinical and Diagnostic Research anaesthetic drugs low concentration local anaesthetics opioids |
| title | Labour Epidural Analgesia: A Randomised Double Blind Comparative Study of 0.1% Levobupivacaine with Fentanyl vs. 0.1% Ropivacaine with Fentanyl |
| title_full | Labour Epidural Analgesia: A Randomised Double Blind Comparative Study of 0.1% Levobupivacaine with Fentanyl vs. 0.1% Ropivacaine with Fentanyl |
| title_fullStr | Labour Epidural Analgesia: A Randomised Double Blind Comparative Study of 0.1% Levobupivacaine with Fentanyl vs. 0.1% Ropivacaine with Fentanyl |
| title_full_unstemmed | Labour Epidural Analgesia: A Randomised Double Blind Comparative Study of 0.1% Levobupivacaine with Fentanyl vs. 0.1% Ropivacaine with Fentanyl |
| title_short | Labour Epidural Analgesia: A Randomised Double Blind Comparative Study of 0.1% Levobupivacaine with Fentanyl vs. 0.1% Ropivacaine with Fentanyl |
| title_sort | labour epidural analgesia a randomised double blind comparative study of 0 1 levobupivacaine with fentanyl vs 0 1 ropivacaine with fentanyl |
| topic | anaesthetic drugs low concentration local anaesthetics opioids |
| url | https://jcdr.net/articles/PDF/11769/31764_CE[Ra1]_F(SL)_PF1(AJ_SL)_PFA(AJ_MJ_AP)_PB(AJ_SL)_PN(SL).pdf |
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