0.2% ropivacaine with fentanyl in the management of labor analgesia: A case study of 30 parturients

BACKGROUND: Epidural infusion of 0.2% ropivacaine is recommended by the manufacturers for labor analgesia. AIMS: The aim of this study is to evaluate the analgesic efficacy, degree of motor blockade, obstetric outcome in the form of incidence of normal vaginal, assisted vaginal and lower segment cesarean section. SETTINGS AND DESIGN: Pilot study. MATERIALS AND METHODS: In this pilot study, 30 nulliparous parturients in active labor had epidural analgesia established using 0.2% ropivacaine with 25 mcg fentanyl for initiation when cervical dilatation was 3–4 cm and then analgesia was maintained with 0.2% ropivacaine at 10 ml/h till the delivery of baby. STATISTICAL ANALYSIS: It was done by Wilcoxon sign rank test and paired t-test as applicable. RESULTS: There was a significant difference (P < 0.05) between prebolus, postbolus and postinfusion with respect to visual analog score. There was a significant difference (P > 0.05) between prebolus, postbolus, and postinfusion with respect to Bromage motor score, (Wilcoxon sign rank test). Six out of 30 paturients complained of tingling and heaviness in lower limbs after continuous infusion of 2–2.5 h. CONCLUSION: We conclude that 0.2% ropivacaine (8 ml) with fentanyl 25 mcg is good for initiation of ambulatory labor analgesia. But for maintenance of labor analgesia lower concentration of ropivacaine may be preferred.