Continuous Peridural Anaesthesia - Element of Comfort Associated with Vaginal Birth

M. Moisa, M. C. Moisa, T. Enache, C. Pop, V. Nicolau, M. Mitran, B. Marinescu

Abstract: Were assessed the effects of the epidural analgesia upon the way of birth appreciated as spontaneous/instrumental birth/caesarean section, both globally and comparative between ropivacaine (R) and bupivacaine (B). Were assessed also the effects of the local anaesthetics used (R and B) on foetal outcome. After the obtaining of the consent of the Hospital Ethic Committee, we studied a group of 430 parturients, 200 in group R and 230 în group B. Patients were primigravidas or multiparas, ASA I-II, age, degree of maternal block the way of birth. The quality of analgesia showed no significant differences between group R and B. Motor block was more intense în group B. Spontaneous birth 77%, out of which 51% needed ocytocic perfusion, vidextractor 15.9%, forceps 3.6%, CS 3%. Fetal assessment showed Apgar score 10 in 38% cases, and 9 în 51% cases. The administration of ropivacaine determined a less intense bloc, allowing the more active participation of the parturient, resulting a higher incidence of spontaneous vaginal births. The versatility offered by CPA may fulfil the variable demands which appear in the labor dynamics, in spontaneous vaginal birth, the instrumental one or CS. The minimal impact on foetal outcome, the low cardio and neurotoxic level, the minimal motor block recommends Ropivacaine as local anaesthetic, the most suitable for CPA at birth.
Keywords: birth, pain, peridural, Ropivacaine