Comparision of ropivacaine 0.2% with or without clonidine in epidural labor analgesia: A randomised controlled study

Abstract

Epidural labour analgesia is considered as the gold standard of pain relief for paturients inspite of the hesitancy that is prevalent in our country in providing pain-free labour.  There are several other pharmacological and non pharmacological methods available for providing labour analgesia. Local anaesthetic is an indispensable drug for administering epidural labour analgesia Ropivacaine is the most widely used local anaesthetic for labour analgesia because of its safety profile proven by various studies.It is less potent and onset of action is slightly prolonged when compared to bupivacaine or levobupivacaine. Use of adjuvants along with local anaesthetic reduces the total dose of local anaesthetic that is required for providing effective labour analgesia. Clonidine is a centrally acting partial alpha 2 adrenergic agonist that reduces the anaesthetic and analgesic requirement of local anaesthetic. This study is aimed to study the effect of ropivacaine with clonidine as an adjuvant for labour analgesia.To compare the time of onset of analgesia, total dose of local anaesthetic required, total duration of analgesia and neonatal outcome between the two groups, Group I with ropivacaine and Group II ropivacaine with clonidine.: A prospective randomised controlled study was conducted in a government peripheral medical College after getting ethical committee clearance 100 patrurients randomised  into two groups, Group I received 2% ropivacaine and Group II received 2% ropivacaine with 40 micrograms of clonidine.: The results were analysed with SPSSVersion 13 using student t - test and chi square test The mean age was 23.4  ±1.7 years. The mean onset time of Group A and Group B were 12.9±1.3 minutes and 17.7±1.3 minutes with p<0.001 which was significant. Total mean dose of Ropivacaine for both groups were 44.0±8.8 and 54.0±8.9 respectively with P <0.05.  Neonatal outcome as measured using APGAR score were 8.5±0.5 and 8.4±0.5 being statistically insignificant.Addition of 40 micrograms of clonidine with Ropivacaine epidurally resulted in rapid onset of analgesia with required dose of Ropivacaine. Use of Clonidine as adjuvant didn't produce any undesirable motor blockade or neonatal depression.