Journal of AdvancedMedical and Dental Sciences Research

Background: labour pain is one of the most excruciating pain experienced by a woman during her childbirth. Had it not been intermittent probably it would have killed many of the women during her first childbirth. The labour pain serves no useful function in human being rather it adversely affects some physiological response in human body. When used alone epidural opioids have been unable to provide adequate analgesia throughout labour, but the addition of the short acting, lipid soluble opioid fentanyl to bupivacaine has been more successful. It remains unclear, however, whether combinations of opioids and bupivacaine appreciably reduce the incidence of operative deliveries and whether enhanced analgesia outweighs the inconvenience of using a controlled drug. Hence; we evaluated the effect of bupivacaine and bupivacaine in combination with epidural fentanyl for labour anaesthesia. Materials & Methods: The present study was conducted in the department of gynaecology of the institution and included all the patients reporting from 2013 to 2015. Ethical approval was taken from the ethical committee of the institution and written consent was obtained from all the subjects involved in the study after explaining them the entire research protocol. Group A comprised of patients who were topped up by either a midwife or an anaesthetist with 5 ml of 0-25% bupivacaine; this was repeated after five minutes unless the mother's pain had disappeared. On the other hand, group B included all those patients who received either 4 ml of 0 .25% bupivacaine for pain restricted to the abdomen, or 10 ml of 0-1% bupivacaine containing 50 µg fentanyl if they had perineal pain. All the results were analyzed by SPSS software. Chi-square test and student t test was used for assessment of level of significance. Results: Mean age of patients in group A and group B was 27 and 27.5 yuears respectively. Mean weight of the patient in group A and group B was 74.5 and 76.2 Kg respectively. Mean dilatation of cervix at initial time in group A and group B was 3.1 and 3 cm respectively. L2-3 lumbar space was used most of the times in both the groups. Mean time required from epidural to the point of delivery in group A and group B was 372 and 331 minutes respectively. Total amount of bupivacaine used in group A and group B was 95 mg and 60 mg respectively. Out of all patients in group A and Group B, 20 and 40 patients underwent normal non-surgical delivery respectively.  In the surgical deliveries, delivery by the use of simple forceps was the most common in both the groups. Caesarean sections were performed in 20 and 14 cases respectively in both the study groups. While comparing the patient overall satisfactory and side-effect, significant difference was obtained. Conclusion: Epidural analgesia provides early encouraging results in patients thereby providing ultimate solution for optimum regimen.
Key Words: Bupivacaine, Fentanyl, Labour