Background: Bupivacaine and Ropivacaine are widely used to provide efficient epidural analgesia in labour. The value of bupivacaine is limited by the risks of motor blockade and toxicity. There have been conflicting comparisons of ropivacaine and bupivacaine for labour analgesia.(1-3) motor block than bupivacaine while others found the drugs to be indistinguishable. In addition most of the studies are in western women and whether those results can be accepted for Indian women remains to be seen. We decided to test for ourselves which localanesthetic solution would be better.

Methods: Our study population was 60 primigravida women who came for delivery to ESIC Medical College PGIMSR-Rajajinagar Bangalore. After meeting our inclusion criteria they were randomly allocated to either group B to receive 0.125% Bupivacaine- 2μg/ml fentanyl solution or group R to receive 0.125%ropivacaine-2μg/ml fentanyl solution. Double blinding was used for all cases. We used the intermittent injection technique after an initial bolus and recorded the following parameters: Oxygen saturation, Heart rate, MAP, Fetal heart rate, Pain score assessed by using visual analogue scale (VAS) 0-10, Degree of motor blockade, mode of delivery and patient satisfaction. The data was analyzed using student t test and chi square test.

Results: VAS scores were significantly lower in group B showing that Bupivacaine was better than ropivacaine in terms of analgesia. MAP was lower in group B showing that in terms of hemodynamic stability ropivacaine was somewhat better; however there was not a single case of hypotension that needed vasopressor use. Mean SpO2, maternal andfetal HR was similar in both groups; Motor block was significantly more with group B than with group R suggesting that in terms of walking epidural ropivacaine was better. Mode of delivery was not different in both groups. Lastly patient satisfaction was significantly better in group B showing patients if given a choice would choose Bupivacaine in their next pregnancy.

Conclusion: We conclude that both Bupivacaine and Ropivacaineare excellent local anesthetics for labor analgesia. Though the pain scores and patient satisfaction were better with Bupivacaine, motor block, hemodynamics and drug toxicity have to be kept in mind before choosing the local anesthetic in the laboring parturient. Some studies have suggested that ropivacaine produces less