Intrathecal isobaric ropivacaine - fentanyl versus intrathecal isobaric levobupivacaine - fentanyl for labor analgesia using single shot spinal technique: Controlled comparative double blinded study.

Abstract

Background and Aims: The study was designed to compare the efficacy of intrathecal isobaric ropivacaine-fentanyl and intrathecal isobaric Levo-bupivacaine-fentanyl for labor analgesia using single-shot spinal technique, with respect to duration of analgesia, progress of labor and its outcome, block characteristics, hemodynamic changes in mother and various side effects in mother and fetus.

 Methods: Sixty multipara parturients in active labor were divided into two groups. Group R received isobaric ropivacaine 0.25% 2.5 mg with fentanyl 25mcg and Group L received isobaric levobupivacaine 0.25%2.5 mg withfentanyl25mcg.Pulse, blood pressure and oxygen saturation, fetal heart rate, and progress of labor were monitored.

 Results: We observed effective labour analgesia which lasted up to 90 minutes in the levobupivacaine- fentanyl group and up to the 75minutes in the ropivacaine-fentanyl group.The time to achieve as <3 was also significantly lower in Group L. Hemodynamic parameters and the APGAR scores were comparable in both the groups and no fetal respiratory depression was observed. No motor blockade and no delay in progress of labor was observed with any of the groups, with minimal and comparable sideeffects.

Conclusion: To conclude, we found that intrathecal levobupivacaine 2.5mg when used with 25μg of fentanyl, provides excellent and longer pain relief as compared to intrathecal ropivacaine 2.5mg with 25μg fentanyl, for labor analgesia.