A double blind randomized clinical trial to compare the efficacy of bupivacaine and ropivacaine for painless delivery

Abstract

Background & objective: Childbirth is an important phenomenon in the life of the mother and although this experience is the wish of every mother, it also concerns her due to the labor pain and the possible dangers that threaten her. There are several medications for painless delivery, such as epidural analgesia with the help of bupivacaine and ropivacaine. The aim of this study was to compare the efficacy of painless delivery with epidural method by bupivacaine and ropivacaine in women candidates for painless delivery.

Methodology: This study is a double blind randomized clinical trial. In this study, patients were randomly divided into two equal groups of bupivacaine and ropivacaine using cubic random method. The demographic data, incidence of cesarean section and mean birth phases were evaluated. Finally, data were analyzed using SPSS 22 software, ANOVA and T-test.

Results: A total of 112 patients were enrolled in the study. There was no significant difference between the two groups in terms of mean active phase of labor, mean Apgar score of min 1 and 5, incidence of cesarean section and mothers motor block score, but the mean of the second phase of labor and mean use of delivery helping instruments (such as forceps and vacuum) were lower in the ropivacaine group. Also, the mean score of patients' satisfaction was higher in ropivacaine group.

Conclusion: It could be concluded that the combination of ropivacaine and fentanyl versus the combination of bupivacaine and fentanyl was a very suitable combination for controlling labor pain by epidural method, while it did not increase the rate of cesarean section and did not have a negative effect on neonatal Apgar scores of min 1 and 5, it had a significant effect on decreasing the mean of second stage of labor, decreasing the use of delivery helping instruments and increasing patient satisfaction score.

Key words: Bupivacaine; Ropivacaine; Epidural analgesia; Painless delivery

Citation: Anousheh N, Shokrpour M, Pazouki S, Kamali A. A double blind randomized clinical trial to compare the efficacy of bupivacaine and ropivacaine for painless delivery. Anaesth. pain intensive care 2021;25(3): 274–279.  DOI: doi.org/10.35975/apic.v25i3.1146

Received: November 2, 2020, Reviewed: February 22, 2021, Accepted: March 26, 2021