SPINAL-EPIDURAL ANALGESIA

Objectives: To compare the efficacy of bupivacaine 2.5 mg and fentanyl 25 ìgwith bupivacaine 1.25 mg and fentanyl 25ìg for spinal-epidural analgesia in the first stage oflabor. Study Design: Double-blind randomized controlled trial. Setting: Anesthesia Department,Surgical Intensive Care Unit, and Pain management clinic, Peoples Medical College HospitalNawabshah. Period: August 2014 to July 2015. Methodology: All the participants meeting theeligibility criteria were randomly allocated into two groups i.e. intervention (I) and control (II),with the allocation ratio of 1:1. Patients in the Group I (intervention) received intrathecal Inj.Bupivacaine 1.25 mg (0.5% Bupivacaine 0.25ml) and Inj. Fentanyl 25 ìg whereas the GroupII (control) was given intrathecal Inj. Bupivacaine 2.5 mg (0.5% Bupivacaine 0.5ml) and Inj.Fentanyl 25 ìg for combined spinal epidural analgesia, both made up of total volume of 2 ml ofnormal saline. Mean±SD (standard deviation) was computed for continuous data (age, weight,VAS). Frequency and percentages was calculated categorical data. Independent t test and Chisquare test were used for the differences between the groups. Results: The age of all the caseswas 27.64±4.07 years. Moreover, groups were homogenous at baseline (p<0.05) in terms ofmean age, weight, cervical dilatation, gravida, and ASA classification. Mean pain score on VASwas not significant between groups at 0 min and 15 min however mean pain score was foundsignificantly low (p<0.05) in group-I. Likewise, efficacy of Bupivacaine 1.25 mg and Fentanyl 25ìg (group-I) was significantly higher than the other group. Conclusion: Low-dose bupivacaine1.25 mg was significantly more effective than high-dose (2.5 mg) bupivacaine when added to25 ìg of fentanyl for combined spinal-epidural analgesia in the first stage of labor, having fewerchances of sensory and motor block, and hypotension.