Ropivacain in Labour Analgesia

Started by yogenbhatt1, October 23, 2009, 01:45:25 PM

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yogenbhatt1

HI,
I have started using Ropivacain for Labour Analgesia for some time. I am still trying to come to a proper dosage, concentration and combination.
Though the literature( Published by manufacturer) says that 0.2 % along with 2mcg of Fentanyl is the best combination, we are not happy with it.
We have tried out many permitation and combination, and now we are giving 0.12% with Fent 1 mcg/ml (15 ml each dose)
This is the best combination so far.
But the patient gets no feel of contraction at all.
Shall I go a bit lowers still?
It acts nicely for almost 150 mins per dose.
would like to learn more from you all.
Please guide us.
Regards

Dr. Mian

At my institution we have ropivacaine 0.15% and 0.075% (both alongwith sufentanyl 2 mcg/ml) available to us.  Most of us including myself use the higher concentration for labor analgesia with good results although what you mentioned (very dense abdominal analgesia) certainly is the norm apart from some perineal pressure at delivery time presumably due to sacral sparing.

yogenbhatt1

HI,
It is great to know that 0.075% Ropivacain is available ready made. I have never tried that mixture. You satisfied with that low concentration? Do let me know. I will also try it out. Sufent is not available here in India. Please send more of your observations.
Regards.

Dr. Mian

0.075% ropivacaine seems relatively well tolerated and provides adequate postop analgesia, especially if pt. is allowed a prn IV NSAID (eg. ketorolac)