Abstract

Background: Childbirth is a painful event but suffering from it is optional. Since the availability of epidural analgesia during labor, it has become a milestone in obstetric analgesia because millions of parturients all over the world are opting it during childbirth because of effective pain relief.

Objective: This study was conducted to compare onset duration of sensory and motor blockade and quality of analgesia of intrathecal bupivacaine 1.25 mg and fentanyl 25 µg in combined spinal epidural technique in early stage of labor.

Materials and Methods: Sixty primigravid or second gravid belonging to ASA grade I and II with singleton pregnancy, cephalic presentation in active labor were selected. Used bupivacaine 1.25 mg and fentanyl 25 µg made to 2 ml with normal saline for group I and bupivacaine 2.5 mg and fentanyl 25 µg made 2 ml with normal saline for group II.

Result: The onset of analgesia was 204 s in group I and 87 s in group II after initial spinal component of combined spinal–epidural analgesia CSEA. The average dermatomal level of sensory blockade achieved was T9 in group I and T7–T8 in group II. Variation in pulse and blood pressure is minimal in group II.

Conclusion: Needle technique of CSEA has rapid onset of action with 1.25mg of bupivacaine and fentanyl 25μg. It has minimal effect of motor blockade, sensory blockade and Blood pressure with rapid onset of analgesia achieved within 4–10 min.

Key words: Bupivacaine 2.5 mg, fentanyl 25 µg, bupivacaine 1.25 mg, sensory block, motor block