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THE COMPARISON OF 0.125% BUPIVACAINE+2MCG/ML FENTANYL AND 0.0625% BUPIVACAINE+2MCG/ML FENTANYL IN PATIENT CONTROLLED EPIDURAL ANALGESIA DURING LABOR
ESRA Academy. Tuncer Peker T. Sep 8, 2016; 138292
Topic: Obstetric Population
Assoc. Prof. Tulay Tuncer Peker
Assoc. Prof. Tulay Tuncer Peker

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Abstract
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Background and Aims:

We aimed to compare the maternal and fetal effects of two different concentrations of bupivacaine combined with fentanyl for patient controlled epidural analgesia (PCEA) during labor. 

Methods:

Following instutional ethical committee approval, sixty ASA I-II primiparous women were randomly allocated into 4 groups. Parturients in groups I-II received an initial dose of 10 ml bupivacaine 0.0625% and fentanyl 25 mcg. For PCEA, bupivacaine 0.0625%-fentanyl 2 mcg/ml solution was used as 2 ml bolus with 10 min lock-out interval in group I, and 4 ml bolus with 20 min interval in group II. Parturients in groups III-IV received an initial dose of 10 ml bupivacaine 0.125% and fentanyl 25 mcg. For PCEA, bupivacaine 0.125%- fentanyl 2 mcg/ml solution was used as 2 ml bolus with 10 min lock-out interval in group III, and 4 ml bolus with 20 min interval in group IV. VAS levels, number of received bolus doses, duration of labor, Apgar scores, maternal and obstetrician's satisfaction scores were recorded. 

Results:

In groups III-IV VAS levels were lower than groups I-II during labor and at delivery. Number of received PCEA bolus doses were higher in groups I-II compared to groups III-IV. Duration of labor, and Apgar scores showed no difference between groups. Maternal and obstetrician’s satisfaction scores were higher in groups III-IV compared to groups I-II. 

Conclusions:

Bupivacaine 0.125%-fentanyl 2mcg/ml combination offered better analgesia compared to bupivacaine 0.0625%-fentanyl 2mcg/ml for PCEA during labor. The analgesic efficacy did not change when the same concentrations were delivered with different bolus doses and lockout periods.

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