Effectiveness of single shot spinal analgesia with 0.2% ropivacaine in comparison to 0.2% levobupivacaine for labour analgesia

Gunmeet Kour; Shivani Sharma; Gurbir Singh

doi:10.18203/2320-6012.ijrms20243716

Authors

Gunmeet Kour Department of Anaesthesia, Government Medical College, Jammu, Jammu and Kashmir, India
Shivani Sharma Department of Anaesthesia, Government Medical College, Jammu, Jammu and Kashmir, India
Gurbir Singh Department of General Surgery, All India Institute of Medical Sciences, Vijaypur, Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20243716

Keywords:

Spinal analgesia, Ropivacaine, Levobupivacaine, Labour pain

Abstract

Background: Labour pain results in a maternal stress response that is not beneficial for the fetus or mother. Spinal analgesia may be a valuable alternative for relieving labour pain. Ropivacaine and levobupivacaine are the drugs commonly used in spinal analgesia. Objectives were to study the efficacy of single-shot spinal analgesia in labour regarding the onset, quality and duration of analgesia, motor blockade, and labour outcome by either ropivacaine or levobupivacaine.

Methods: A prospective observational study conducted in SKIMS, Srinagar which included 60 pregnant women who had received labour analgesia. The patients were divided into two groups. In group I, patients received 1 ml of heavy ropivacaine (0.5%) and in group II patients received 1 ml of heavy levobupivacaine (0.5%). Parameters recorded and assessed were the time of onset of analgesia, duration of epidural analgesia, duration of the first and second and total duration of labour, mode of delivery, fetal heart rate, APGAR scores of the newborn, patient complaints after spinal anaesthesia and mean arterial pressure (MAP), heart rate, visual analogue pain scale (VAS) of the subjects.

Results: The two groups showed no statistical difference with respect to different parameters like age, weight, height, gestational age, body mass index (BMI) and cervical dilation before the block. There was statistically significant difference with respect to the time of onset and duration of analgesia, in two groups. No significant difference was seen, in terms of VAS scores across different time periods.

Conclusions: There was comparable efficacy in terms of analgesic characteristics in both the groups, but levobupivacaine has a longer duration of analgesia, which is helpful for the effective functioning of labour and patient’s satisfaction.

Metrics

Metrics Loading ...

References

Shnider SM, Abboud TK, Artal R, Henriksen EH, Stefani SJ, Levinson G. Maternal catecholamines decrease during labor aft er lumbar epidural anesthesia. Am J Obstet Gynecol. 1983;147:13-5.

Pearson JF, Davies P. The effect of continuous lumbar epidural analgesia upon fetal acid-base status during the first stage of labour. J Obstet Gynaecol Br Commonw. 1974;81:971-4.

Dyer RA, Reed AR, James MF. Obstetric anaesthesia in low-resource settings. Best Pract Res Clin Obstet Gynaecol. 2010;24(3):401-12.

American Society of Anesthesiologists Task Force on Obstetric. A. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. 2007;106(4):843-63.

Hocking G, Wildsmith JAW. Intrathecal drug spread. Brit J Anaesth. 2004;93:568-78.

Antonakou A, Papoutsis D. The Effect of Epidural Analgesia on the Delivery Outcome of Induced Labour: A Retrospective Case Series. Obstet Gynecol Int. 2016;20:1-5.

Mousa W, Al-Metwalli R, Mostafa M. Epidural analgesia during labor vs no analgesia: A comparative study. Saudi J Anaesth. 2012;6(1):36.

Cheng Q, Zhang W, Lu Y, Chen J, Tian H. Ropivacaine vs. levobupivacaine: Analgesic effect of combined spinal-epidural anesthesia during childbirth and effects on neonatal Apgar scores, as well as maternal vital signs. Exp Ther Med. 2019;18(3):2307-13.

Purdie NL, McGrady EM. Comparison of patient-controlled epidural bolus administration of 0.1% ropivacaine and 0.1% levobupivacaine, both with 0.0002% fentanyl, for analgesia during labour. Anaesthesia. 2004;59(2):133-7.

Das A. Comparison of the effects of intrathecal bupivacaine, levobupivacaine and ropivacaine for lower abdominal surgeries: A double blind randomized controlled study using isobaric preparations. Int J Inf Res Rev. 2015;2(4):636-41.

Kumar TS, Rani P, Hemanth Kumar V, Samal S, Parthasarathy S, Ravishankar M. Quality of labor epidural analgesia and maternal outcome with levobupivacaine and ropivacaine: A double-blinded randomized trial. Anesth Essays Res. 2017;11(1):28.

Rahmati J, Shahriari M, Shahriari A, Nataj M, Shabani Z, Moodi V. Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia. Anesth Pain Med. 2021;11(2):e113350.

Chhetty YK, Naithani U, Gupta S, Bedi V, Agrawal I, Swain L. Epidural labor analgesia: A comparison of ropivacaine 0.125% versus 0.2% with fentanyl. J Obstet Anaesth Crit Care. 2013;3:16-22.

Chethanananda TN, Shashank MR, Madhu N, Achyutha J, Siva Kumar KV. Comparative efficacy of minimal concentration of racemic bupivacaine (0.0625%) with fentanyl and ropivacaine (0.1%) with fentanyl for epidural labor analgesia. Anesth Essays Res. 2017;11(3):583-8.

Viitanen H, Viitanen M, Heikkila M. Single-shot spinal block for labour analgesia in multiparous parturients. Acta Anesthesiol Scand. 2005;49:1023-9.

Kuczkowski KM, Chandra S. Maternal satisfaction with single-dose spinal analgesia for labor pain in Indonesia: a landmark study. J Anesth. 2008;22(1):55-8.