Comparison of the Effectiveness of Epidural Anesthesia with Two Different Combination, Bupivacaine plus Meperidine versus Bupivacaine Plus Fentanyl in Duration of Labor and Cesarean Section Rate

Comparison of the Effectiveness of Epidural Anesthesia with two different combination, Bupivacaine Plus Fentanyl versus Bupivacaine plus Meperidine in Duration of Labor and Cesarean Section Rate

In this study, 264 eligible women who are candidates for normal delivery and are included in the study and will be randomly divided into two groups after obtaining informed consent.

This study will be conducted on women referring to Arash Women's Hospital. Once the informed consent has been achieved, randomization will be performed. The random allocation list is only available to the group's epidemiologist and participants and researchers as well as the statistics counselor will be unaware of how the participants are assigned. For subjects after infusion of 7 cc / kg of ringer serum after confirmation of the patient entering the active phase of the first stage of labor, appropriate monitoring is performed and patient will be placed in a sitting position. After desensitizing the needle insertion place with two to three milliliters of lidocaine 2%, 18-gauge epi-dural needle will be inserted by using the loss of resistance technique. after a test dose with 3 ml of lidocain plus epinephrine, Epidural Anesthesia will be done with bupivacaine plus fentanyl in the first group and with bupivacaine plus meperidine in the second group and the catheter will be fixed in the epidural space. The patient then will be place in sleeping position and will be obsrved untill delivery .if be necessary, a vaginal examination is performed in the lithotomy position.

Patients participating in the study must be aged between 18 and 40 years old, tendency to painless delivery, ASA Class I, and II-BMI <35. Women with obstetrical or medical contraindication (mitral valve stenosis) for NVD are not included in the study.

In the first group, 15 cc of bupivacaine 125 % with 50 μg fentanyl and in the second group 15 cc bupivacaine 125 % with 25 mg of meperidine is injected into the epidural space and the catheter is fixed in the epidural spaces.

- Duration of the active phase of labor - Duration of the second stage of labor - Score of Pain Relief - Cesarean section Rate - Apgar Score

Our sample size is 264 people, with 132 people in each group. Block randomization method was designed by epidemiologist using stata version 13 software. The number of blocks considered is 6.

The random allocation list for patients is solely available to the epidemiologist. To hide the random allocation process, 264 sequences of treatments will be written accordingly, and then the cards will be placed in sealed envelopes. On each 10-digit random code packet, the order is written and the framework is written that the patient identification number is relevant and the methodologist will simply be aware of the design of the code. When an anesthesiologist announces the eligibility of a patient, the methodologist will provide the anesthesiologist with the envelope. The analgesia method is selected based on the type mentioned in the envelope. None of the patients should be aware of the type and treatment process they are seeking. Also, the person evaluating the outcomes is the third person who is unaware of the random allocation process and type of treatment. To analyze the data, a statistician who is separate from the study process and who is unaware of all the processes performed will be used.

because we plan to use our data in another studies thus we dont intresting to sharring that