Comparison of the length of stage II labor and incidence of forceps and cesarean delivery after epidural infusion of 0.125% bupivacaine with 2 mu/mL fentanyl as compared with 0.0625% bupivacaine with 2 mu/mL fentanyl.

A large, retrospective chart review was conducted to analyze the length of stage II labor and instrumental and cesarean-section delivery rates in nulliparous women who received either 0.0625% bupivacaine with 2 mu/mL fentanyl or 0.125% bupivacaine with 2 mu/mL fentanyl. Data collected included length of stage II labor, incidence of operative or instrumental delivery rates, concentration of bupivacaine used, and demographic data. Demographics obtained included maternal age, weight, and height, as well as neonatal gestational age, weight, and Apgar scores. Further investigated were additional analgesic requirements of supplemental boluses of local anesthetic between the groups. No differences in demographics were noted between the groups. Instrumental delivery rates were similar between the groups with an incidence of 17.5% in the 0.125% bupivacaine group versus a 15% incidence in the 0.0625% bupivacaine group. Cesarean delivery rate was 17% in the 0.125% bupivacaine group versus a 21% ratio in the 0.0625% bupivacaine group. Duration of stage II labor was noted to be prolonged in the 0.125% bupivacaine group but was not statistically significant. Based on this data, it can be concluded that the use of 0.125% bupivacaine with 2 mu/mL fentanyl does not cause a statistically significant increase in instrumental or cesarean delivery rates, nor does it have a detrimental effect on length of stage II labor.