Bupivacaine 0.125% versus bupivacaine 0.125% with different doses of fentanyl for epidural labour analgesia: A randomised double blind study
Dhara Patel, Prerana Mankad, Sahil Bansal, Jayendra Makwana, Shakuntala Goswami, Bharat Shah.
Background: Epidural analgesia is the most commonly used method for labour analgesia.
Aims & Objective: To evaluate the safe dose of fentanyl added to Bupivacaine 0.125% and its effect on quality and duration of analgesia with side-effects.
Materials and Methods: Forty-five healthy nulliparous women, ASA physical status I and II with an uncomplicated pregnancy and single fetus in vertex position were given lumbar epidural analgesia. Patients in Group A (n=15) received Bupivacaine 0.125 percent; Group B (n=15) and C (n=15) received the same agents as Group A but with addition to the initial dose of 2 mcg/ml or 4 mcg/ml of fentanyl respectively. All the patients were evaluated for duration and quality of analgesia, duration of labour, method of delivery and side effects.
Results: Addition of either 2 mcg/ml or 4mcg/ml of fentanyl resulted in longer duration of analgesia (132.2 ± 12.4 minutes and 188.20 ± 18.5 minutes respectively versus 92.5 ± 10.2 minutes) and also decreased number of top up doses significantly. Quality of analgesia was better in Group B and Group C as compared to Group A. Addition of fentanyl did not affect the duration of labour, the method of delivery and fetal outcome.
Conclusion: Combination of Fentanyl 2 mcg/ml and Fentanyl 4 mcg/ml with Bupivacaine 0.125% is both and safe for providing labour analgesia via epidural route.
Key words: Epidural Analgesia; Bupivacaine; Fentanyl