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Fentanyl added to bupivacaine 0.05% or ropivacaine 0.05% in patient-controlled epidural analgesia in labour

Published online by Cambridge University Press:  16 August 2006

L. Pirbudak
Affiliation:
Gaziantep University, Department of Anaesthesiology, Gaziantep, Turkey
S. Tuncer
Affiliation:
SelÇuk University, Department of Anaesthesiology Konya, Turkey
H. Koçoğlu
Affiliation:
Gaziantep University, Department of Anaesthesiology, Gaziantep, Turkey
S. Göksu
Affiliation:
Gaziantep University, Department of Anaesthesiology, Gaziantep, Turkey
Ç. Çelik
Affiliation:
SelÇuk University, Department of Obstetrics and Gynaecology, Konya, Turkey
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Abstract

Background and objective: Epidural analgesia is the most effective method for pain relief during labour. The aim was to elucidate the efficacy of ropivacaine 0.05% and bupivacaine 0.05%, which were both combined with fentanyl 0.00015% to provide analgesia in labour.

Methods: Forty nulliparous females were enrolled into the study. After insertion of an epidural catheter, patients were randomly assigned into two groups. Once the os uteri had dilated to 4–5 cm, a bolus of bupivacaine 0.125% 10 mL + fentanyl 50 μg (1 mL) in Group 1 patients, and ropivacaine 0.125% 10 mL + fentanyl 50 μg (1 mL) in Group 2 patients was administered via the epidural catheter. Then, patient-controlled epidural analgesia was started with a basal infusion of bupivacaine 0.05% 10 mL h−1 + fentanyl 0.00015% 1.5 μg mL−1 in Group 1, and ropivacaine 0.05% + fentanyl 1.5 μg mL−1 in Group 2. When needed, a 10 mL bolus infusion could be given and the lockout time was 20 min. Maternal and fetal haemodynamic variables were monitored before induction and subsequently at 5 min intervals. Using a visual analogue scale assessed the degree of pain.

Results: Maternal haemodynamic variables and Apgar scores were not different between the two groups. The second stage of the labour was shorter in Group 2 (P < 0.01). There were no significant differences in patients’ assessment of motor block or mode of delivery between groups.

Conclusions: An epidural infusion (10 mL h−1) of bupivacaine 0.05% or ropivacaine 0.05% together with fentanyl 1.5 μg mL−1 provided good and safe analgesia during labour.

Type
Original Article
Copyright
2002 European Society of Anaesthesiology

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