COMPARATIVE STUDY OF CONTINUOUS EPIDURAL INFUSION OF BUPIVACAINE 0.125% AND ROPIVACAINE 0.2% WITH FENTANYL AS ADJUVANT FOR LABOUR ANALGESIA.

Background:- Epidural analgesia is the most popular method which can provide excellent pain relief yet, allows the mother to be awake and cooperative during labour. In comparision to bupivacaine, Ropivacaine is less lipid soluble, less cardiotoxic, with less motor block and better haemodynamic stability. Objective:- To study and compare the continuous epidural infusion of Ropivacaine with Fentanyl versus Bupivacaine with Fentanyl for labour analgesia . Methodology:- 100 healthy primigravid women, aged 18 to 35 yrs, > than 37 weeks gestation, with spontaneous onset of labour were selected. An epidural catheter was inserted at L2-L3 or L3- L4 level. It was activated after 4cm cervical dilatation with test dose of 3ml 1% lignocaine with 1:200,000 epinepherine. The parturients were randomized into two groups. In Bupivacaine group 8 ml 0.125% Bupivacaine Fentanyl 25 ug followed by continuous infusion of 0.125% Bupivacaine and injection Fentanyl 2 ug /ml at the rate of 6ml/hr was given. In Ropivacaine group 8 ml 0.2% Ropivacaine + Inj Fentanyl 25 ug followed by continuous infusion of 0.2% Ropivacaine with injection Fentanyl 2ug /ml at the rate of 6ml /hr was given. Monitoring was done hrly until they reached 10 cm dilatation and the following data were recorded: maternal blood pressure and heart rate, fetal heart rate, VAS score, motor block , sensory level, mode of delivery, Apgar score, and maternal satisfaction. Results:- In our study, motor block was observed in 13(26%) patients in the Bupivacaine group whereas only five (10%) patients had motor block in Ropivacaine group (P < 0.05) and Eight patients in Bupivacaine group and two patients in Ropivacaine group delivered by assisted vaginal deliveries (P < 0.05). There were no significant differences between the two groups in patient characteristics, maternal haemodynamic variables and patient satisfaction. Conclusion:- Ropivacaine 0.2% combined with fentanyl 2 mcg mL (-1) provided effective analgesia with significantly less motor block and less need