July 2017 · Volume 6 · Issue 7 Page 2836
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Taneja A et al. Int J Reprod Contracept Obstet Gynecol. 2017 Jul;6(7):2836-2840
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
Fetomaternal outcome in high-risk parturients receiving epidural
analgesia using fentanyl with ropivacaine versus iv tramadol: a
comparative study
Ashima Taneja
1
*, Kamaldeep Arora
2
, Isha Chopra
1
, Anju Grewal
3
,
Sushree Samiksha Naik
4
, Geetika Sharma
1
INTRODUCTION
Pain during labour is one of the worst experiences in the
life of a woman, and its relief is an important issue.
1
Most
women request for some forms of analgesia
(pharmacological/non-pharmacological) to get rid of this
excruciating pain. Few women also opt for caesarean
section to avoid the bad experience of painful labour
and/or episiotomy. Painful labour also reduces utero-
placental blood flow.
1
To counter all these, effective
analgesia is needed to eliminate/attenuate pain in labour.
2
Various pain-relieving methods are available since long
time that include: systemic administration of medications,
inhalational medications, transcutaneous nerve
stimulation (TENS), neuro-axial blockade, and epidural
analgesia. Of them, epidural analgesia is the most
accepted method as it has been found to be both safe
(both for the mother and the neonate), and effective.
3-6
However, there is some doubt regarding its effect on the
duration of labour (some think that it may increase the
ABSTRACT
Background: Labour analgesia has been recommended but sufficient data on use of labour epidural analgesia with
ropivacaine and fentanyl combination during labour is not available.
Methods: A comparative study was conducted on 40 high risk labouring partuirents, randomly allocated to group A
(iv tramadol) and group B (epidural analgesia with ropivacaine plus fentanyl). Assessments were done for fetal heart
rate abnormality, mode of delivery, duration of labour, and Apgar score. The VAS score, patient satisfaction score,
and complications were recorded.
Results: Group A had more number of instrumental deliveries compared to group B, the later had higher number of
caesarean sections. No difference was observed in vaginal deliveries in both the groups. Pain relief was significant in
patients of epidural group. The neonatal outcome was same in both the groups. Significant number of patients had a
higher degree of satisfaction score in group B compared to group A.
Conclusions: Tramadol and epidural analgesia in labour are safe and effective. Patient satisfaction is significantly
higher in epidural group as compared to the tramadol group.
Keywords: Epidural analgesia, Labour, Outcome, Tramadol, Vaginal delivery
DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172611
1
Department of Obstetrics and Gynecology, Dayanand Medical College, Ludhiana, Punjab, India
2
Department of Pediatrics, Dayanand Medical College, Ludhiana, Punjab, India
3
Department of Anaesthesia, Dayanand Medical College, Ludhiana, Punjab, India
4
Department of Obstetrics and Gynecology, AIIMS, Bhubaneswar, Odisha, India
Received: 24 May 2017
Accepted: 07 June 2017
*Correspondence:
Dr. Ashima Taneja,
E-mail: kauraashima@gmail.com
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