Downloads: 0
Comparative Study | Medicine | Volume 15 Issue 5, May 2026 | Pages: 69 - 73 | India
Comparative Evaluation of 0.1% Levobupivacaine versus 0.1% Ropivacaine with Nalbuphine as Adjuvant in Epidural Labor Analgesia: A Randomized Controlled Study
Abstract: Background: Epidural analgesia remains the gold standard for managing labor pain, combining local anesthetics with opioid adjuvants. Levobupivacaine and ropivacaine are widely preferred due to their favorable safety profiles; however, direct comparative evidence when combined with nalbuphine as an adjuvant is limited. Objectives: To compare the analgesic efficacy, hemodynamic stability, motor blockade, neonatal outcomes, and adverse effect profiles of 0.1% levobupivacaine with nalbuphine 5 mg (Group LN) versus 0.1% ropivacaine with nalbuphine 5 mg (Group RN) for epidural labor analgesia. Methods: This prospective randomized controlled study enrolled 72 ASA II primigravida parturients in active labor at MGM Hospital, Navi Mumbai between September 2022 and November 2023. Patients were allocated equally (n=36 per group) to receive either 0.1% levobupivacaine with 5 mg nalbuphine (Group LN) or 0.1% ropivacaine with 5 mg nalbuphine (Group RN) via the epidural route. Pain intensity was assessed using the Numeric Rating Scale (NRS), motor block by the Modified Bromage Score, and hemodynamic parameters, neonatal Apgar scores, and labor duration were recorded at standardized intervals. Results: Group LN demonstrated significantly faster onset of analgesia (4.6 ± 0.25 min vs. 5.6 ± 0.24 min, p<0.01) and longer duration of analgesia (135.2 ± 12.5 min vs. 120.8 ± 9.7 min, p<0.01) compared to Group RN. NRS scores were significantly lower in Group LN from 15 to 90 minutes (p<0.01). Group LN also exhibited superior hemodynamic stability and shorter total labor duration. Neonatal Apgar scores were comparable between groups (p>0.05). Adverse effects including hypotension, nausea/vomiting, urinary retention, pruritus, and postpartum hemorrhage were more frequent in Group RN. Conclusion: 0.1% Levobupivacaine with nalbuphine provides superior analgesic efficacy, better hemodynamic stability, shorter labor duration, and a more favorable safety profile compared to 0.1% ropivacaine with nalbuphine for epidural labor analgesia, making it the preferred agent in this clinical setting.
Keywords: Levobupivacaine, Ropivacaine, Nalbuphine, Epidural analgesia, Labor analgesia, Numeric Rating Scale, Motor blockade, Hemodynamic stability, Neonatal Apgar score
How to Cite?: Dr. Anusha Nadupuri, Dr. Jessy, Dr. Ritika Negi, "Comparative Evaluation of 0.1% Levobupivacaine versus 0.1% Ropivacaine with Nalbuphine as Adjuvant in Epidural Labor Analgesia: A Randomized Controlled Study", Volume 15 Issue 5, May 2026, International Journal of Science and Research (IJSR), Pages: 69-73, https://www.ijsr.net/getabstract.php?paperid=MR26501103255, DOI: https://dx.dx.doi.org/10.21275/MR26501103255