A Comparative Study of 0.0625% Bupivacaine-Fentanyl With 0.1% Ropivacaine-Fentanyl for Labor Epidural Analgesia

TL;DR

This study compares two epidural analgesia solutions for labor pain, finding that 0.1% ropivacaine-fentanyl provides better pain relief and satisfaction than 0.0625% bupivacaine-fentanyl.

Contribution

The study introduces a direct comparison of two low-concentration epidural analgesia mixtures for labor pain management.

Findings

Ropivacaine-fentanyl (RF) provided significantly better analgesia with lower VAS scores at 20 and 30 minutes.

RF resulted in higher maternal satisfaction and less motor block compared to bupivacaine-fentanyl (BF).

Neonatal outcomes and labor duration were comparable between the two groups.

Abstract

Introduction: Labor pain triggers significant maternal stress, impacting both maternal and fetal well-being. Epidural analgesia is the gold standard for labor pain relief, offering effective analgesia with minimal side effects. This study compares the efficacy and safety of 0.0625% bupivacaine-fentanyl (BF) versus 0.1% ropivacaine-fentanyl (RF) in labor epidural analgesia.

Materials and methods: An observational study was conducted on 60 primiparous women in active labor, divided into two groups (n=30 each). Group BF received 0.0625% BF (2 mcg/ml), and Group RF received 0.1% RF (2 mcg/ml) via epidural infusion. Pain relief (Visual Analog Scale (VAS) score), motor block (modified Bromage score), need for top-ups, maternal satisfaction, mode of delivery, neonatal outcomes (Apgar scores), and adverse events were recorded. Data were analyzed using Epi Info (Centers for Disease Control and Prevention (CDC), Atlanta, Georgia), with p<0.05 considered significant.

Results: Both groups were demographically comparable. Group RF demonstrated superior analgesia with significantly lower VAS scores at 20 and 30 minutes (p=0.007 and p<0.001). Group BF required more top-ups and rescue analgesia. Motor blockade was significantly higher in Group BF (p=0.0074). Maternal satisfaction was better in Group RF (p=0.0005). Apgar scores and labor duration were comparable. No significant hemodynamic instability or adverse events were noted.

Conclusion: A combination of 0.1% RF provides superior analgesia with less motor block and higher maternal satisfaction compared to 0.0625% BF in labor epidural analgesia, without compromising neonatal outcomes.

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