EPIDURAL ANALGESIA FOR LABOUR PAIN: EFFECT ON LABOUR, DELIVERY AND NEONATAL OUTCOME OF 0.125% BUPIVACAINE vs 0.125 % LEVOBUPIVACAINE

Mihir Gupta; Priya Sharma; Uma Srivastava

Volume : VIII, Issue : VII, July - 2019

EPIDURAL ANALGESIA FOR LABOUR PAIN: EFFECT ON LABOUR, DELIVERY AND NEONATAL OUTCOME OF 0.125% BUPIVACAINE vs 0.125 % LEVOBUPIVACAINE

Mihir Gupta, Priya Sharma, Uma Srivastava

Abstract :

Introduction: Bupivacaine provides excellent analgesia for labour and delivery and remains the most widely used epidural local anaesthetic in obstetric anaesthesia. The newer local anaesthetics are significantly less cardio-toxic and neurotoxic than bupivacaine. Aims: To compare low dose levobupivacaine and bupivacaine in same concentration during epidural technique regarding efficacy of analgesia. Material and Methods: 60 parturients were randomly allocated to two groups of 30 each: GROUP B-received an initial epidural dose of 15 ml 0.125% bupivacaine with 3 mcg/ ml fentanyl and GROUP L-received an initial epidural dose of 15 ml 0.125% levobupivacaine with 3mcg/ ml fentanyl. Assessment of pain relief were carried before epidural injection and then at 10min interval for first 30mins and at hourly interval. Motor blockade was assessed using a modified omage scale. Results:1) Both the groups provided equivalent labour analgesia and maternal satisfaction. 2) Bromage score >=1 was observed in 4 patients in group B and 2 patients in group L.3) Similar distribution of highest level of cutaneous sensory loss in pin prick was observed in both groups(p>0.05). 4) The total dose of bupivacaine was slightly less than levobupivacaine but statistically insignificant. The total dose of fentanyl was also lower in group B but was statistically insignificant(p>0.05). 5). There was no significant difference between the two groups regarding - the incidence of pruritus, hypotension, backache, vomiting, shivering. Pruritus was noted in 5 parturients in group L compared to 4 in Group B (p>0.05). Conclusion: Both the regimes were equally effective in providing ambulatory labour analgesia with equivalent maternal satisfaction and neonatal outcome.