Effects of epidural analgesia on mother and fetus produced with bupivacaine plus fentanyl and bupivacaine plus burenorphine during delivery

Objective: To determine and compare the maternal and fetal effects of the administration of epidural analgesia with a mixture of bupivacaine 0.25% more buprenorphine 3 mcg/kg, with the epidural analgesia with a mixture of bupivacaine more fentanyl or with bupivacaine alone. Material and methods: We studied 45 pregnant women with gestational age greater of 32 weeks, ASA class not greater of III, and in which exists initial obstetric conditions that permits the vaginal delivery. The patients were randomly assigned to one of three groups in order to receive epidural analgesia with: bupivacaine like only anesthetic drug (group B), bupivacaine plus fentanyl 100 mcg (group BF), or bupivacaine plus buprenorphine 3 mcg/kg (group BB). Results: The obtained analgesia and the level of sensitive blockade were satisfactory for the patients of the three groups, but of better quality for the groups BF and BB. The patients of the group BF had a time of resolution of the of labor significantly minor, as well as minor necessity of dose of rescue. The hemodynamic behavior of the patients of the three groups was similar. We didn't find differences statistically significant in the Apgar scores to the minute and five minutes of the birth between the neonates of the three groups. Conclusions: We concluded that the epidural analgesia with a mixture of bupivacaine, to low dose, more buprenorphine 3 mcg/kg of maternal meager weight represents a viable, effective and sure option for the mother and the neonate. In the short-term, the mixture of bupivacaine and fentanyl 100 mcg, is more effective and equally sure, and it favor a quicker evolution of the obstetric conditions of the labor with excellent analgesia until the delivery. Both techniques, compared with a technique based on the use of local anesthetics like only drug, provide advantages of comfort, effectiveness and security for the mother and the neonate.