A COMPARISON OF ROPIVACAINE 0.125% VERSUS ROPIVACAINE 0.0625% WITH FENTANYL.

Background : To minimize the concentration of local anaesthetics by comparing the sensory and motor effects by two different concentrations with or without adjuvants. Aim: . To compare the efficacy of epidural analgesia using 0.125% Ropivacaine versus an 0.0625% Ropivacaine with 2µg/ml Fentanyl for labour analgesia. Methods : A total of 60 parturients in active labour were randomly assigned into two groups (R and R+F) of 30 patients each, to receive an epidural injection of 15 ml of Ropivacaine 0.125% in R group and 15 ml Ropivacaine 0.0625% with Fentanyl (2 µg/ml) in group R+F as initial bolus dose. Same dose regimen were used as subsequent top-up dose on patients demand for pain relief. The duration and quality of analgesia, motor block, top-up doses required consumption of Ropivacaine and Fentanyl and feto-maternal outcome in both groups Result:  Epidural top-up technique using 0.125% Ropivacaine (group R) analgesia was similar to that using 0.0625% Ropivacaine (group R+F) with 50µg Fentanyl, but motor power was retained allowing women to mobilize. There also appear to be beneficial effects on the progress of labour, with a clinically important reduction in the length of the second stage. . Conclusion : Our study resulted that establishing epidural analgesia in labour with 15ml of 0.125% Ropivacaine ( in group R) followed by top- ups of 10ml of 0.125% Ropivacaine, produced similar analgesia to that obtained from the same volume of 0.0625% Ropivacaine with 2µg Fentanyl (in group R+F), but motor block was minimized (termed as Walking Epidural ) . No significant neonatal depression was seen in our study. So it would be better to give 0.0625% Ropivacaine with 2µg Fentanyl for better management of pain in obstetric patients without any effect on fetal respirationand better management of labour pain.