A clinical study of labour using epidural analgesia with 0.125% bupivacaine and its outcome

Author: 
Thillai Nachiyar. R., Latha. K, Jayashree.V, Sekaran. N.K

Background: Minimum effective concentration of local anesthetics for providing optimal labour epidural analgesia and the strategies aiming to reduce their consumption are continuously being searched.
Objectives: The objective of this study was to evaluate the efficacy of 0.125% bupivacaine for epidural labour analgesia.
Materials and Methods: This was a prospective study carried out in department of obstetrics and gynaecology in Rajah muthiah Medical College and Hospital from 2015-2017 after ethical clearance and written knowledgeable concent. A total of 100 parturients in both latent and active phase of labour were to receive an epidural injection of 12 ml of bupivacaine 0.125% as initial bolus dose. Same dose regimen was used as subsequent top-up dose on patients demand for pain relief. The duration and quality of analgesia, motor block, top-up doses required consumption of bupivacaine and feto-maternal outcome were observed.
Results: Effective labour analgesia with minimal motor blockade was observed with no failure rate. Onset of analgesia was significantly faster. Duration of analgesia after initial bolus dose was also significantly reduced. Mean VAS scores were significantly less after bupivaccine. There were no significant changes in hemodynamics, nor adverse effects related to neonatal or maternal outcomes.
Conclusion: We conclude that the concentrations of bupivacaine (0.125%) are effective in producing epidural labour analgesia and was found superior in terms of faster onset, prolonged duration, lesser breakthrough pain.

Page: 
305-312
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