Resumen:
OBJECTIVE: To quantify the time of labor using ropivacaine 0.2% vs 0.2% bupivacaine epidural.
Assess the quality of obstetric analgesia using the ropivacaine 0.2% versus the bupivacaine 0.2% with
fentanyl in the scale of EVA via epidural.
MATERIAL AND METHODS: We conducted a randomized controlled clinical trial in pregnant
patients of 17-35 years primigravida with 37-40 weeks gestation in labor in active phase, ASA I-II
in the surgical unit of the General Hospital Ecatepec “Las Américas”. Through this simple
randomization, will chosen in one of the two groups. Group R (I): 0.2% ropivacaine plus fentanyl
50mcg, and group B (II): 0.2% bupivacaine plus fentanyl 50 mcg.
We compared the duration of analgesia and calculated the number of additional doses for each
group, we determined the Apgar score of infant for each group and hemodynamic changes were
assessed.
RESULTS: Both ropivacaine & bupivacaine to 0.2% at the same concentration associated with fentanyl is
highly effective in epidural analgesia in labor, being these clinically indistinguishable from one another.
The duration of analgesia shows a difference between group I that was handled with ropivacaine with a
half time in minutes, of 87 ± 38 compared with group II that was handled with bupivacaine 109 ± 23; was
significant with P = 0.002 with Student's T test. The group I of ropivacaine shows a mean of 0.2 ± 0.4 and
the group II of bupivacaine of 55 ± 0.5, with p = 0.004 being significant with Student's T test and Mann
Whitney's U. With hemodynamic changes, no patient in either group showed hypotension, the
hemodynamic changes were minimal in both groups presenting slightly between the groups
changes in heart rate at 25 minutes, for group I of 94 ± 16 & for the group II 89 ± 5 with a value of
p = 0.003 showing significant with the Student's T test.
CONCLUSIONS: The total duration of sensory block was sufficient because it allowed: maintaining good
analgesia in the three periods of in labor, and prevent in occasions a booster for both local anesthetics
studied.