Effectiveness of bupivacaine and levobupivacaine for epidural labour analgesia

The patients will receive nil per oral instructions before the

labour. After shifting the patients to the labour analgesia room,

standard non-invasive anaesthetic monitoring like blood pressure,

five leads electrocardiography and pulse oximetry will be

connected to the patient. Baseline vitals such as heart rate,

blood pressure, mean arterial pressure, and oxygen saturation of

the patient will be recorded after 5 mins settling in the labour

analgesia room. An intravenous line will be established. The

epidural space will be found using an 18-gauge Tuohy needle at

either L2–L3 or L3–L4 in the sitting position. Loss of resistance will

be used to identify the epidural space. Epidural catheter will be

inserted up to the desired length and secured at L2-L3 or L3-L4.

For the study, the test dose will be omitted. Levobupivacaine or

bupivacaine will be diluted with 0.9% w/v saline to achieve the

desired concentration at room temperature. For initiation of labour

analgesia, first bolus administration (12ml of 0.2%) of

levobupivacaine or bupivacaine will be given over 5 minutes when

cervical dilatation will become >3 cm and then analgesia will be

maintained with infusion of 0.1% levobupivacaine or 0.1%

bupivacaine till the delivery of the baby.