| Abstract: |
This work studied the epidural analgesia using Ropivacaine and Bupivacaine with and without fentanyl to assess their efficacy, safety, advantages and! or drawbacks, in pain relief during labour. 60 multiparous parturients in the first stage of labour were studied.Their ages varies from 22 to 34 years, their weights varied from 65 to 105kg, and their cervical dilatation was 4 ern at the onset of the technique.These patients were subdivided into four groups; each of them 15Patients: Group I, Group II, Group III, Group IV. We measured onset of analgesia, degree of pain relief, degree of motor blockade, heart rate, blood pressure, respiratory rate, uterine blood flow, fetal heart rate, Apgar score and pH.The results of this thesis can be summarized in the following data:Epidural analgesia using Ropivacaine with or without fentanyl(group I and II) succeed to achieve pain relief during labour, this with noadverse effects on mother, no adverse effect on progress of labour, thiswith no motor block, and thus with ability to ambulate. Group II recordedrapid onset and better quality of analgesia than group 1.Epidural analgesia using Bupivacaine with or without fentanyl(group III and IV) succeed to achieve pain relieve during labour with noadverse effects on mother, no effects on foetus and with no effect 011progress of labour. Analgesia occur with few cases of motor block, andthus with ability to ambulate. Group IV recorded rapid onset and betterpain relief than group III. Regarding the comparison between the four studied groups indegree of motor blockade group II recorded the best result and thus withability to ambulate, followed by group 1, then group IV, and then GroupIll. Regarding the comparison between the four groups as regard onsetof analgesia and degree of pain relief, group II and group IV recordedbest results than groups 1and III. There were no difference between the four groups as regard duration of labour, maximum level of sensory block achieve, maternalheart rate, maternal respiratory rate, maternal systolic and diastolic bloodpressure, uterine blood flow, foetal heart rate, Apgar score and infantumbilical artery pH.
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