Effects of epidural analgesia using ropivacaine on the mother and the newborn during labor

OBJECTIVE: To evaluate the effects of epidural analgesia using 0.2% Ropivacaine on the mother, newborn and during labor.

METHODS: This study was conducted at the Zeynep Kamil Obstetric, Gynecology, and Pediatric Research and Training Hospital in Istanbul, Turkey, between July 2003 and April 2004. Eighty pregnant women of 37-41 weeks' gestation were enrolled in the study. Forty cases received epidural analgesia (group 1) and the control group composed 40 cases (group 2). Duration of labor, systolic and diastolic blood pressures at initial, 15th, 30th, 45th and 60th minutes, and number of breathing per minute, pulse rates, fetal heart rates and presence of motor block were recorded. Blood gas assessments from the umbilical cord, 1st and 5th minute Apgar scores were noted following the delivery. Way of delivery, adverse effects and complications of the epidural analgesia were recorded.

RESULTS: Mean age of the cases was 24.79 ± 4.72 years. Duration between full cervical dilation and delivery (phase 2) was significantly longer in group 1 (p<0.01). Sixty minutes systolic arterial pressure was significantly lower in group 1 (p<0.05). In group 1, diastolic arterial pressures at 15th, 45th, 60th minutes (p<0.01) and 30th minute (p<0.05) were significantly lower when compared to the initial values. No significant differences were recorded in terms of breathing rates, umbilical cord CO2, O2, pH levels and Apgar scores between the 2 groups. The most common adverse effect of epidural analgesia was sedation (59%). The second dose of Ropivacaine was needed in 24 (61.5%) cases in group 1. In group 1, 29 (74.4%) patients expressed their pleasure as very good regarding the epidural analgesia.

CONCLUSION: Epidural analgesia, if administered by a specialist to a properly selected patient at proper time, leads to a comfortable delivery by relieving the pain. It can be performed safely after taking an informed consent.