Key result
Ropivacaine with fentanyl cuts labor demand boluses by ~78% versus levobupivacaine with fentanyl.
Why the study?
Pregnant women experience severe labor pain that causes stress and anxiety, prompting a comparison of patient-controlled epidural analgesia regimens.
Does 0.1% ropivacaine with fentanyl compared to 0.1% levobupivacaine with fentanyl improve analgesia requirements and mode of delivery in labouring parturients?
RCT (n=30)
Randomly into 2 groups
No
Does 0.1% ropivacaine with fentanyl compared to 0.1% levobupivacaine with fentanyl improve analgesia requirements and mode of delivery in labouring parturients?
Absolute Event Rate: 0.08% vs 0.36%
p-value: p=0.01
Both 0.1% ropivacaine and 0.1% levobupivacaine with fentanyl provide equivalent analgesia for labor, though ropivacaine was associated with fewer demand boluses.
May favor ropivacaine for fewer supplemental doses in labor; extends RCT comparisons of epidural local anesthetics.
Background: Pregnant women experience severe labor pain which is the leading cause of stress and anxiety. The present study compared 0.1% ropivacaine and 0.1% levobupivacaine with 2 µg/ml fentanyl as a patient controlled epidural analgesia. Materials and Methods: 30 labouring parturients were divided into 2 groups of 15 each. Group I patients received 0.1% ropivacaine with 2 µg/ml fentanyl and group II patients received 0.1% levobupivacaine with 2 µg/ml fentanyl as epidural solutions via PCEA pump infusions. Results: Mode of delivery found to be caesarean seen in 5 in group I and 7 in group II, instrument‑assisted vaginal delivery seen 8 in group I and 6 in group II and normal vaginal delivery seen 7 in group I and 7 in group II. The difference was non- significant (P> 0.05). Demand boluses per hour was 0.08 in group I and 0.36 in group II, mean total number of manual rescue boluses was 1.02 in group I and 0.61 in group II and first requirement of manual rescue bolus was 3.10 in group I and 2.60 in group II. The difference was significant (P< 0.05). Conclusion: Both bupivacaine and ropivacaine produced equivalent analgesia with fentanyl for labor.
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Gupta et al. (2021) conducted an RCT in Labor pain (n=30). 0.1% ropivacaine with 2 µg/ml fentanyl vs. 0.1% levobupivacaine with 2 µg/ml fentanyl via PCEA pump was evaluated on Demand boluses per hour (p=0.01). 0.1% ropivacaine with fentanyl resulted in significantly fewer demand boluses per hour compared to 0.1% levobupivacaine with fentanyl (0.08 vs 0.36, p=0.01) during labor.
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