Comparison of 0.1% Ropivacaine and 0.0625% Bupivacaine With Fentanyl as an Adjuvant for Labour Analgesia.

Background and aims Effective pain relief during labour is an important component of obstetric care, with epidural analgesia being the most reliable method. Using low concentrations of local anaesthetics combined with opioids can provide adequate analgesia while minimizing adverse effects. In this study, we compared the analgesic effectiveness of 0.1% ropivacaine and 0.0625% bupivacaine, each administered with fentanyl (2 mcg/mL), for epidural labour analgesia. Methods A double-blinded randomized controlled study was conducted with 40 parturients belonging to ASA physical status I or II. They were divided into two groups of 20 each by computer-generated block randomization. Group A received bolus doses of 0.0625% bupivacaine with 2 mcg/mL fentanyl. Group B received bolus doses of 0.1% ropivacaine with 2 mcg/mL fentanyl. The outcomes assessed included hemodynamic stability, sensory blockade, motor blockade, pain score using a visual analogue scale (VAS), number of supplemental doses, total drug consumption, first and second stages of labour duration, mode of delivery, maternal satisfaction, outcomes of the newborn, and adverse effects such as hypotension, bradycardia, nausea, and vomiting. Results The sensory blockade onset was significantly faster in Group A compared to Group B (p = 0.03). VAS scores were significantly lower in Group A at 5 minutes (p < 0.0001), 10 minutes (p = 0.0003), 15 minutes (p = 0.02), 1 hour (p < 0.001), and 2 hours (p = 0.0002). Group A also required fewer additional doses and demonstrated lower overall drug consumption (p = 0.02). Maternal satisfaction scores were significantly higher in Group A (p = 0.01). Conclusion Epidural labour analgesia with 0.0625% bupivacaine with fentanyl (2 mcg/mL) provides superior analgesic efficacy, faster onset, and reduced drug requirements compared to 0.1% ropivacaine with fentanyl (2 mcg/mL), while maintaining a comparable safety profile.