EFFECT OF ADDITION OF DEXMEDETOMIDINE 0.5 mcg/ml WITH 0.2% ROPIVACIANE AND 0.2% ROPIVACAINE ALONE IN EPIDURAL LABOUR ANALGESIA: A RANDOMIZED COMPARATIVE STUDY

Abstract

Introduction: The pain of childbirth is often rated by women as being most painful experience of their lives. It is estimated that about two third of normal healthy pregnant women, suffer severe intolerable pain during labour and only 2% describe it as little or no discomfort. There are several factors which influence parturition pain and its severity varies widely. It is influenced by parity, primiparous women experience more pain during early labour while multiparous women feel greater pain in the second stage.
Materials and Methods: This prospective, comparative study was conducted at Department of Anaesthesia, ESIC Medical College and Hospital, Kalaburagi during the period of January 2022 to December 2022, written consent was obtained from all parturients in the study. The sample size obtained was 60 for each group. So final sample size estimated was 120. Group RS received 0.2% ropivacaine epidurally as bolus dose of 8 mL followed by intermittent top ups as and when required and Group RD received 0.2% ropivacaine with 0.5 mcg/mL of dexmedetomidine epidurally 8 mL as bolus dose followed by intermittent top ups as and when required. A complete history of each patient was obtained, and clinical examination was done. Routine investigations along with coagulation profile was obtained and noted. All baseline parameters like Heart Rate, Blood Pressure, ECG, SpO2, Foetal Heart Rate were recorded
Results: Demographic and obstetric variables were comparable in both the groups and with no statistical significance which was calculated by calculated by independent sample t-test with Levene’s test for equality of variances. To assess the neonatal status APGAR score (table 1) at 1 and 5 mins was evaluated. It was found that there was NO statistically significant difference in mean APGAR score at1 min (p=1.000) and 5 mins (p=0.309).
Conclusion: Epidural labour analgesia is considered to be a gold standard for pain management during labour, when ropivacaine along with dexmedetomidine is used. Many studies have beenconducted to prove the use of dexmedetomidine in obstetric anesthesia in optimal doses. This wonder drug provides excellent maternal satisfaction and good progress of labour with minimal side effects to mother and foetus.