Journal of AdvancedMedical and Dental Sciences Research

COMPARISON OF 0.0625% BUPIVACAINE WITH 0.0002% FENTANYL V/S 0.0125% BUPIVACAINE IN AMBULATORY LABOR EPIDURAL ANALGESIA

Introduction: Epidural analgesia is considered at present to be the most effective and innocuous technique of providing labor analgesia. The present  study aimed  to compare the efficacy of 0.0625% bupivacaine + 0.0002% fentanyl V/S 0.125% bupivacaine for the labor analgesia and motor blockade and also evaluated the two drug regimen for their effect on ambulation. Material and Methods:            40 ASA1 physical status female were divided into two groups. Group A comprised of 20        patients who received 0.0625% bupivacaine and 0.0002% fentanyl. Group B comprised of 20 patients who received 0.125% bupivacaine. Results: Mean time to effective analgesia was 35.71+13.84 min in group A and 18+8 min in group B and was significantly higher in group A than in group B (p value<0.005). Patients in group B had faster and excellent analgesia in 100% of cases. All the patients in group A could ambulate without support as compared to only two patients in group B. Conclusion: 0.125% bupivacaine provides excellent analgesia in 100% of cases, though it does not allow ambulation in all patients. Labor analgesia with 0.0625% bupivacaine + 0.002% fentanyl causes very minimal block and thus allows ambulation in 100% of cases, though it provides good quality of analgesia in 75% of the parturients.  Quality of analgesia can be probably improved by increasing the concentration of bupivacaine in initial bolus, which further needs to be evaluated.
Key words: Walking epidural; ambulatory epidural; labor analgesia.