Comparison of Patient Controlled Analgesia with Bupivacaine or Bupivacaine plus Fentanyl during Labor - Abstract
Objective: In this study, we aimed to compare the efficacy of low dose bupivacaine vs. bupivacaine plus fentanyl, both administered via PCA, for pain relief during labor.
Materials and Methods: A total of 40 healthy pregnant women in the active phase of labor were included and randomly allocated into the two following PCA analgesia groups: 0.125% bupivacaine (Group B) and 0.125% bupivacain + 2 ?g/ml fentanyl (Group BF).
Hemodynamic parameters were recorded. Fetal heart rate and uterine contractions were monitored.
Also recorded were the time of onset of analgesia, pain score, sensory and motor block levels, and adverse effects, as well as amount of solutions required by the pregnant, bolus volumes administered, total solution volume used in PCA, mode of delivery and the result of initial newborns examination. Mothers were asked to rate their level of satisfaction with analgesia after delivery.
Results: Onset of analgesia was more rapid in group BF than in group B. Subjects in Group BF had higher sedation, less pain, and less marked motor blockade than group B. The first phase of labor and total time of labor were shorter in Group BF. Volumes of solutions required by the pregnant women and of boluses given during the first phase were also lower in group BF. Satisfaction of pregnant women was higher in group BF. No significant differences were found in other variables between study groups.
Conclusion: We conclude that bupivacaine and fentanyl combination provides higher quality of analgesia and better patient satisfaction in labor than bupivacaine alone.