지속적 통증조절기를 이용한 경막외강으로 Fentanyl을 첨가한 0.125% Ropivacaine과 0.125% Bupivacaine 주입시 분만통 조절에 대한 효과

A Double-blind Comparison of 0.125% Ropivacaine with Fentanyl and 0.125% Bupivacine with Fentanyl for Labor Analgesia Using Patient-Controlled Epidural Infusion

Background: This study intends to evaluate the benefits of the administation of continuous infusion and demand doses of 0.125% ropivacaine compared with 0.125% bupivacaine after addition of fentanyl using patient controlled epidural analgesia (PCEA) for pain control during labor. Methods: Thirty-nine American Society of Anesthesiologists physical status 1 or 2 parturients were randomized by double blind design to receive either 0.125% bupivacaine with fentanyl 1 ug/ml or equivalent concentration of ropivacaine/fentanyl using PCEA; with 6~8 ml/hr basal rate, 3 ml bolus, 5 min lockout, 30 ml/hr dose limit. We assessed analgesia, the amount of study solution used in PCEA, sensory levels, motor block (0~3 scales), side effects and patient satisfaction. A postpartum questionnaire was carried out afterward. Results: There were no differences in visual analogue scores (VAS) for pain, hourly study solution use, sensory levels, side effects and patient satisfaction between groups. However, patients administered ropivacaine/fentanyl had significantly less demand, less administered in PCEA, less numbness and restriction of movement compared with patients in the bupivacaine/fentanyl group. Conclusions: Ropivacaine 0.125% with fentanyl, when administerd epidurally by PCEA for labor analgesia, was equally efficious as bupivaciane 0.125% with fentanyl, having with minimal numbness and restriction of motion.