COMPARITIVE STUDY ON QUALITY OF ANALGESIA WITH TWO DIFFERENT DOSES OF EPIDURALLY ADMINISTERED BUPIVACAINE IN COMBINED SPINAL EPIDURAL LABOUR ANALGESIA

DR.J.AROCKIA MICHAEL RAJA; Dr. N.R.KARTHIC KUMAR

Volume : VII, Issue : XII, December - 2017

COMPARITIVE STUDY ON QUALITY OF ANALGESIA WITH TWO DIFFERENT DOSES OF EPIDURALLY ADMINISTERED BUPIVACAINE IN COMBINED SPINAL EPIDURAL LABOUR ANALGESIA

Dr. J. Arockia Michael Raja, Dr. N. R. Karthic Kumar

Abstract :

Combined spinal epidural analgesia is most preferred labour analgesia because of its good quality of analgesia.Eventhough labour analgesia which has many proven benefits, not popular in developing countries like india because of myths like increased rate of instrumental and operative delivery , increased risk of motor blockade which adversely affect the progress of labour. By using low dose and ultra low dose concentrations of local anesthetic agent decreases the adverse effects without affecting the quality of analgesia.In our study, we compare the combined spinal epidural technique with two different low concentrations of bupivacaine (0.0625% vs 0.1%) for quality of analgesia. To initiate analgesia we used intrathecal fentanyl 25 mcg in both the groups and we also add fentanyl 2mcg per ml in epidural preparations of bupivacaine to improve the quality in both the groups. Group I: receive intrathecal fentanyl 25µg+epidural 0.1% bupivaccaine 10 ml with 2µg of fentanyl/ml Group II: receive intrathecal fentanyl 25 µg +epidural 0.0625% bupivaccaine 10 ml with 2µg of fentanyl/ml Both the groups are comparable in age ,height ,weight, parity and timing of initiation of labour analgesia.Quality of analgesia was excellent in both groups which was assessed by patient’s satisfaction at the end of delivery Onset of analgesia in both groups was comparable But the total dosage of bupivacaine used in group I was 29.67 mg with SD of 3.198, in group II mean was 18.02 with SD of 1.575. p–value of 0.0000 which was statistically very significant. 76.67% in group I and 80% in group II had experienced pruritus which was mild and self limiting in most of the parturients.