Comparative Study of Epidural Bolus Administration of 0.1% Bupivacaine and 0.1% Bupivacaine Plus 0.0002% Fentanyl for Analgesia during Labour

Document Type : Original Article

Authors

1 Associate Professor of Obstetrics & Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Anesthetists, Omul-Banin Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Associate Professor of Biostatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Resident in Obstetrics & Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:Epidural analgesia is a popular technique for pain relief of labor but using local anesthetic agents solitarily may produce motor block or be associated with a prolonged second phase and increased incidence of instrumental delivery. Thus, adding an opioid to local anesthetic solutions may provide effective and perfect analgesia.
 
Methods: This study is designed to compare epidural bupivacaine and a combination of epidural fentanyl and bupivacaine in induction of painless delivery among pregnant women who were subjected to normal vaginal delivery at Omul-Banin hospital’s maternity ward between 2007-2008. Our patients in this study divided into two groups. In the group A, anesthesia was induced by 15cc of 0.1% bupivacaine whereas in group B it was induced by 15cc of 0.1% bupivacaine plus 50 μg of fentanyl. Pain was assessed using Visual Analogue Scaling (VAS) every 10 minutes till delivery. Motor function was also assessed by Bromage scoring.
 
Results: Both groups were similar in their demographic characteristics such as age, BMI, gestational age and educational state along with their obstetrical exams and progress of labor. Reviewing measurements demonstrated better painless interval in group B during labor. Verbal pain scores after anesthesia induction were significantly lower in group B. motor power remained intact in both groups. The most common side-effect was itching which was more frequent in group B.
 
Conclusion: Compared to bupivacaine in solitude, combinations of opioid and bupivacaine may improve the analgesia during labor. This may influence the progress of labor and high maternal satisfaction.

Keywords

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 12, Issue 4 - Serial Number 4
December 2010
Pages 22-29

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