Anesthesia & Clinical Research
Open Access

Abstract

A Comparative Study of Two Different Doses of Fentanyl Added to Bupivacaine for Intermittent Epidural Labor Analgesia: A Prospective Randomized Double Blind Study

Gaurav S. Tomar, Akhilesh Tiwari, Rajan B. Godwin, T C Kriplani, Neeaj Singh Gaur and Ashish Sethi

Background: Intermittent technique of labor epidural analgesia has been showing promising results over other techniques. This study was to assess and compare efficacy of two different doses of fentanyl mixed with low doses of bupivacaine in intermittent labor epidural analgesia.

Methods: 90 ASA grade I-II parturients in active labor with a cervical dilatation of 3 to 5cm were randomly allocated to three different groups-

Group A: 10ml Bupivacaine 0.125% + fentanyl 10μg (1μg/ ml).

Group B: 10ml Bupivacaine 0.125% + fentanyl 20μg (2μg/ ml).

Group C: 10ml Bupivacaine 0.125% (The control group).

All patients were preloaded with 10-15ml/kg Lactated Ringer’s solution. Labor analgesia was maintained by intermittent boluses of the drug combination.

Results: The mean time of onset of analgesia was significantly lower (P<0.05) and the duration of analgesia was significantly higher (p<0.01) in Group B when compared with Group A and group C (p<0.001). The patients satisfaction was considerably better observed in Group B (p<0.01). However in both group’s progression of labor was found to be slightly prolonged than group C. The level of sensory and the motor block was comparable in both the groups was at T8-T10 level and it was comparable and level of motor blockade (bromage score=0, 1) in each group was also not significant (p>0.05).

Conclusion: Addition of fentanyl (2μg/ml) to bupivacaine 0.125% decreases the time of onset of analgesia and increases the duration of analgesia and level of maternal satisfaction during labor as compared to fentanyl (1μg).