A Comparative Study of 0.0625% Bupivacaine–Fentanyl versus 0.1% Ropivacaine–Fentanyl for Labour Epidural Analgesia

Background: Epidural analgesia is considered the gold standard for labour pain relief. The goal of using low-concentration local anesthetic-opioid combinations is to minimise motor blockage and negative effects on mothers and newborns while still providing good analgesia. For labour epidural analgesia, 0.0625% bupivacaine–fentanyl and 0.1% ropivacaine–fentanyl were examined in this study. Materials and Methods: The Department of Anaesthesiology at the Surabhi Institute of Medical Sciences in Siddipet was the site of this prospective comparative study. Two groups of sixty ASA Grade II primiparous women in established labour, ages 20 to 30, were randomly assigned. Group RF (n=30) was given 0.1% ropivacaine with fentanyl, and Group BF (n=30) was given 0.0625% bupivacaine with fentanyl. Analgesic efficacy, sensory and motor blockade, haemodynamic parameters, top-up dose requirements, maternal satisfaction, mode of delivery, and neonatal outcomes were evaluated. Results: The onset of analgesia was significantly faster in Group RF than in Group BF (9.47 ± 1.38 vs. 13.01 ± 1.35 min; p<0.001). Group RF demonstrated significantly less motor blockade, reflected by a higher maximum Bromage score (3.90 ± 0.31 vs. 3.40 ± 0.68; p<0.001), and required fewer top-up doses (1.17 ± 0.79 vs. 2.17 ± 1.18; p<0.001). Pain scores were significantly lower in Group RF at 15 minutes, 25 minutes, 2 hours, and 4.5 hours. Sensory blockade, duration of labour, maternal satisfaction, instrumental delivery rates, neonatal APGAR scores, and haemodynamic parameters were comparable between groups. Conclusion: Both regimens provided effective and safe labour epidural analgesia. However, 0.1% ropivacaine–fentanyl offered faster analgesia, reduced motor blockade, lower pain scores, and fewer top-up requirements, making it a favourable option for labour analgesia.

Keywords: Labour analgesia; Epidural analgesia; Ropivacaine; Bupivacaine; Fentanyl.