Objective: To compare the analgesic efficacy and certain adverse effects of epidural analgesia using 0.0625% bupivacaine versus 0.1% bupivacaine, both combined with 1 mcg/ml fentanyl for labor pain management.
Subjects and methods: Sixty parturients indicated for vaginal delivery were randomly assigned into two groups (n=30): Group 1 received 0.0625% bupivacaine with 1 mcg/ml fentanyl; Group 2 received 0.1% bupivacaine with 1 mcg/ml fentanyl. Both groups received an initial 10 ml bolus followed by a continuous infusion at 8 ml/h.
Results: Both protocols maintained stable low VAS scores (< 3) throughout labor. Group 1 had a significantly longer onset of analgesia compared to Group 2 (12.1 ± 3.2 minutes vs. 9.7 ± 2.5 minutes, p < 0.05). However, Group 1 demonstrated superior motor function preservation, with 100% of parturients achieving a bromage score of 0, whereas 23.33% in Group 2 experienced mild motor weakness (bromage 1) (p < 0.05). Maternal pushing ability in group 1 reached 100% good rating, significantly higher than group 2 (p < 0.05). There was no statistically significant difference in neonatal apgar scores between the two groups (p > 0.05).
Conclusion: The 0.0625% bupivacaine regimen provides analgesic efficacy comparable to the 0.1% concentration while effectively reducing motor blockade and better preserving maternal pushing ability, ensuring safety for both mother and infant.