Comparison of epidural Butorphenol-ropivacaineand Fentanyl-ropivacaine for labour analgesia-Randomized Double Blind Study

Background: Advancement in labour analgesia includes newer local anaesthetics with more selective sensory blockade which permit ambulation of parturient, various technological improvement and newer adjutant which facilitate reduced requirement of local anaesthetics and hence side effect. Objective: The objective of this study was to evaluate the efficacy butorphenol 0.5mg and fentanyl 25 mcg mixed with 0.1% ropivacaine for epidural labour analgesia. Material and Method: After Institutional Ethical approval and written informed consent, 60 full term parturient with spontaneous onset of labour randomly assigned to two equal groups of 30 each, to receive an epidural injection of 12 ml ropivacaine 0.1% with butorphenol 0.5ml (500 mcg) in group B1 and 12 ml of ropivacaine 0.1% with fentanyl 0.5ml (25 mcg) in group L2 as initial bolus dose. Further Top-up of 0.1% ropivacaine was given on patients demand. Duration of analgesia, sedation, hemodynamic parameters, oxygen saturation, Respiratory rate, foetal Apgar score and maternal side effect were compared. Results were analysed by oneway analysis of variance test, Fisher’s exact test or Chi Square test, whichever appropriate. Result: Demographic data and obstetrical characteristics were comparable between two groups. After initial epidural bolus, duration of analgesia was significantly more in group B (90.70±41.21) than in group R (62.80±34.12) (p<0.001). Hemodynamic parameters, VAS Score and side effects were comparable between two groups. Neonatal outcome (Apgar score) was also comparable between two groups. Conclusion: Epidural ropivacaine 0.1% with butorphenol or fentanyl results in satisfactory labour analgesia without any increase in side effects. Duration of analgesia was more in butorphenol group.