Ambulatory epidural analgesia for painless labour: Comparison between bupivacaine plus fentanyl and bupivacaine plus tramadol

Abstract

Background: In modern obstetrics alleviation of labour pains by simple, safe and effective means presents a unique problem. Epidural analgesia has emerged as a popular and relatively safe option. This study was conducted to compare the efficacy of bupivacaine plus tramadol and bupivacaine plus fentanyl for ambulatory epidural analgesia in spontaneous vaginal delivery. Methods: This quasi-experimental study was carried out on 100 patients, ranging from 20 to 30 years age, having American Society of Anaesthesiology status I, primigravida, singleton with cephalic presentation, at PNS Shifa Hospital Karachi. The study was carried out from April 2007 to April 2008. Sampling technique was non-random convenient. Results: In Group-A pain after first dose was reduced at 10 minutes. But in Group B the action was delayed and analgesia was not adequate. After 20 min the analgesic effects in both groups were similar. Bupivacaine with fentanyl was associated with 96% patient satisfaction while bupivacaine with tramadol 92%. Conclusion: Analgesia with bupivacaine plus fentanyl and bupivacaine plus tramadol for ambulatory epidural analgesia in spontaneous vaginal delivery are equal in efficacy.