Revista Brasileira de Anestesiologia
Print version ISSN 0034-7094
GOMES, Marcos Emanuel Wortmann; BALLE, Vanessa Rezende; MACHADO, Sheila Braga and MENDES, Florentino Fernandes. Comparison between 0.125% and 0.25% bupivacaine associated to fentanyl for epidural labor analgesia. Rev. Bras. Anestesiol. [online]. 2004, vol.54, n.4, pp. 467-472. ISSN 0034-7094. http://dx.doi.org/10.1590/S0034-70942004000400002.
BACKGROUND AND OBJECTIVES: Epidural analgesia aims at decreasing or even abolishing maternal suffering during labor. It is considered a safe and effective method for pain relief. This study aimed at comparing two bupivacaine concentrations (0.25% and 0.125%) associated to fentanyl in epidural labor analgesia to determine its efficacy on pain relief and its effect on motor block. We have also observed the influence of these two concentrations on labor duration, fetal outcome and maternal satisfaction. METHODS: Participated in this prospective and double blind study 51 primiparous women who were randomized to receive one out of two bupivacaine concentrations for epidural labor analgesia (0.25% [n = 23] or 0.125% [n = 28]). Analgesia was measured using a numeric pain scale, and motor block was verified using Bromage scale. Means were compared using Student's t test, while proportions were compared using Qui-square test, with p < 0.05. RESULTS: There has been no statistical difference in pain, degree of motor block and fetal outcome between groups. Cesarean delivery rate was statistically higher in the group receiving 0.25% bupivacaine (p < 0.05). Lower concentration group patients were more satisfied with the procedure (p < 0.01). CONCLUSIONS: The association of fentanyl and 0.125% bupivacaine proved to be more beneficial as compared to 0.25% concentration. With this dose, there has been a lower incidence of adverse effects without compromising analgesia, and yet a higher rate of maternal satisfaction.
Keywords : ANALGESIA [labor]; ANALGESICS [Opioids]; ANALGESICS [fentanyl]; ANESTHETICS [Local]; ANESTHETICS [bupivacaine]; ANESTHETIC TECHNIQUES [Regional]; ANESTHETIC TECHNIQUES [epidural].