Priya, R (2015) A Comparative Clinical Study of Epidural 0.125% Bupivacaine with Fentanyl Versus 0.1% Ropivacaine with Fentanyl in a Combined Spinal Epidural Labour Analgesia using Intrathecal Fentanyl. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
BACKGROUND AND OBJECTIVES: The responsibility of the Anaesthesiologist in obstetrics is arguably greater than in any other fields of anaesthesia. The aim of the study is to compare the quality of epidural analgesia of 0.125% bupivacaine with 0.1% ropivacaine after intrathecal administration of fentanyl 25 mcg in combined spinal epidural labour analgesia. METHODOLOGY: Approval was obtained from the Institutional Ethical Committee board. This comparative clinical study of combined spinal epidural labour analgesia for vaginal delivery with intrathecal fentanyl 25 μg initiated in all parturients followed by group B receives epidural 0.125% bupivacaine 10 ml with 2μg of fentanyl/mL and group R receives epidural 0.1% ropivacaine 10 ml with 2μg of fentanyl/mL was conducted in 60 term healthy primi gravida with cephalic singleton pregnancy with 30 in each group, who wished and opted for painless labour after obtaining informed risk consent. Two groups were compared in terms of quality of analgesia using VAS, patient satisfaction, onset and degree of motor & sensory blockade, vitals, fetal heart rate changes, duration of labour, mode of delivery, neonatal outcome and side effects of the drugs. RESULTS: Both groups were comparable in age, height, weight, parity and time of initiation of labour analgesia. Combined spinal epidural analgesia decreases the duration of labour. Patient satisfaction, level of sensory blockade, mode of delivery, duration of labour, neonatal outcome and complications are comparable. Quality of analgesia was excellent in both the groups. Out of 60 parturients, 10 patients (33.3%) in group B and 4 (13.3%) patients in Group R had grade 1 Bromage (minimal) motor blockade. P value (0.67) which was statistically insignificant. Maximum motor blockade (grade 1 Bromage) has occurred during the first stage of labour and was seen immediately following the first epidural bolus dose that doesn’t affect the progression of labour. CONCLSION: The observation of this study shows that both bupivacaine 0.125% and ropivacaine 0.1% administered epidurally as a part of combined spinal epidural technique provides equal and effective quality of analgesia. Motor blockade of grade 1 Bromage was seen relatively more bupivacaine group but that was not statistically significant, it needs further studies in larger scale.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Epidural 0.125% Bupivacaine ; Fentanyl Versus 0.1% Ropivacaine ; Fentanyl ; Combined Spinal Epidural Labour Analgesia ; Intrathecal Fentanyl ; Comparative Clinical Study. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Punitha K |
| Date Deposited: | 07 May 2018 04:30 |
| Last Modified: | 08 May 2018 03:42 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7587 |
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