Intravenous paracetamol as an adjunct to patient-controlled epidural analgesia with levobupivacaine and fentanyl in labour: a randomized controlled study

Labour is reported to be one of the most painful experiences for many women. Epidural analgesia is the most effective treatment available for pain control during labour and delivery, and it is a preferable method because it can provide more effective pain relief compared with other form of pharmacological analgesia. .The review of literature in the area of labour analgesia indicates that significant progress has been made with the advent of PCEA using a combination of low-concentration long-acting local anaesthetics (bupivacaine, levobupivacaine) and low-dose lipid soluble potent opioids (e.g., fentanyl). However, there is still scope of further improving the scenario by studying whether addition of a long-established safe and well-tolerated analgesic like paracetamol by the intravenous route to the intrapartum labour analgesia regime as above can reduce the total hourly consumption of the anaesthetic-opioid combination by the epidural route. If demonstrated to have PCEA drug-sparing effect, then this new regime could enhance the safety of the entire procedure for both mother and child without compromising analgesic efficacy.Therefore the aim of present study is to evaluate the efficacy of intravenous infusion of 1000 mg of paracetamol as an adjunct and its sparing effect on total consumption of levobupivacaine and fentanyl combination given as patient controlled epidural analgesia in labouring parturients