“COMPARACION DE ROPIVACAINA VS BUPIVACAINA VIA PERIDURAL PARA ANALGESIA OBSTETRICA”

Abstract

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.