Effect of Epidural Bupivacaine Versus Intrathecal Single Dose inAnalgesia during Normal Vaginal Labor of Multiparous Women

Abstract

AbstractBackground: Epidural analgesic technique is the mostcommonly used and most effective analgesia during labor.Intrathecal labor analgesia is alternatively and effective methodto provide labor analgesia.Aim of Study: To compare the effect of epidural bupi-vacaine versus single-dose intrathecal bupivacaine duringlabor of multiparous women on the duration of labor analgesia,progress of labor, block characteristics and side effects.Material and Methods: In a prospective randomizeddouble-blind study, 80 multiparous women of ASA class Iand II were randomly allocated into two groups of pregnantwomen 40 each. The spinal group received hyperbaric bupi-vacaine 0.5% at a dose of 3.75mg (0.75ml) of hyperbaricbupivacaine with 25ug fentanyl (0.5ml) and diluted withsterilized normal saline to 1.5ml whereas the epidural groupreceived isobaric bupivacaine 8-10ml of 0.125% bupivacainewith fentanyl 50mg. Patients were monitored for hemodynam-ics, sensory and motor block characteristics, side effects,duration of stages of labor and pain intensity was also recorded on a visual analogue scale.Results: Maternal hemodynamics showed a nonsignificantchanges between both groups. Onset of sensory block andduration were significantly delayed in epidural group incomparison to spinal group (8.80±5.27, 163±16.64min) vs (4.6± 1.20, 120.2±3.33min) and visual analogue scale comparable in both groups but scale was lower in the spinal group. Patient's satisfaction was insignificantly more in S group. The duration of the first and second stages of labor in the spinal group was shorter than that in the epidural group and incidence of maternal complications in both groups were insignificant.Conclusion: A safe and effective alternative method toepidural analgesia is a single-dose intrathecal bupivacaine.