To Compare the Effects of Intermittent versus Continuous Administration of Epidural Ropivacaine with Fentanyl for Labour Analgesia at Govt. T.D. Medical College, Alappuzha.

Corresponding Author:
Nadarajan Veena,
Additional Professor,
Department of Anesthesiology,
Government T. D. Medical College,
Alappuzha, Kerala, India.
E-mail: drveenadutt@gmail.com

ABSTRACT

BACKGROUND

Labour analgesia improving the maternal and neonatal outcome is time proven. Primary objective was to compare the quality of analgesia using visual analogue scale and secondary objectives were to assess the progress of labour, incidence of instrument assisted delivery, total dose of drug used in each technique, neonatal outcome and the incidence of maternal side effects.

METHODS

A prospective interventional study was done in 40 willing Primigravida (20 in each group) with uncomplicated singleton term gestation admitted to labour room during the period of 1 year after obtaining ethical clearance. Sample size calculated was 25 using the formula 4pq/d² with 80 % power. Statistical analysis was done by SPSS v16 software. Association was tested using chi square test for qualitative variables and quantitative variables was tested using independent sample t test. Statistical significance between the VAS scores was tested using Mann Whitney test.

RESULTS

Demographic variables, pain scores, motor block and neonatal outcome were comparable in both the groups. The total drug requirement (p-0.5) and duration of second stage (p-0.08) were less and incidence of hypotension (p - 0.29) and rescue dose requirement (p-0.6) was more in intermittent bolus group. Instrumental delivery was higher in continuous infusion group. All parturients developed urinary retention.

CONCLUSIONS

Low volume of 0.2% ropivacaine with 2 mcg/mL fentanyl was effective in alleviating labour pain. Both techniques were equally effective and can be recommended for labour analgesia.

KEY WORDS

Labour Analgesia, Epidural, Intermittent Bolus, Continuous Infusion, Ropivacaine 0.2%