Single-shot spinal buprenorphine with low-dose bupivacaine for labor analgesia: A prospective interventional study on maternal and fetal outcomes

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Background: Labor pain can be intense and have an impact on both the mother and the fetus. Single-shot spinal analgesia using buprenorphine and low-dose bupivacaine is a simple, effective, and cost-efficient alternative to epidural analgesia. Aim: To investigate the effects of single-dose spinal analgesia with buprenorphine (ITN) and bupivacaine on maternal and fetal outcomes Materials and Methods: This prospective interventional study was conducted in the Department of Obstetrics and Gynecology, SMGS Hospital, Jammu, over one year from October 2021 to September 2022. A total of 100 parturients in active labor with cervical dilatation ?3 cm were enrolled and divided into two groups. The study group received intrathecal buprenorphine 50 ?g with bupivacaine 1 mg, while the control group underwent natural labor without analgesia. Maternal hemodynamic parameters, labor characteristics, mode of delivery, fetal outcomes, Visual Analogue Scale (VAS) scores, and complications were assessed. Results: The second stage of labor was significantly shorter in the study group (23.29 ± 17.35 min) compared with the control group (37.34 ± 31.56 min) (p=0.0089). VAS scores significantly decreased within 5 minutes following spinal analgesia (1.34 ± 0.74 vs 8.35 ± 0.52; p<0.0001). Mean duration of analgesia was 224.6 ± 143.6 minutes. No significant differences were observed in cesarean section rate, instrumental delivery, CTG abnormalities, or APGAR scores between the groups. Maternal side effects were minimal and manageable. Conclusion: Single-shot intrathecal labor analgesia using buprenorphine with low-dose bupivacaine provides rapid, effective, and prolonged pain relief without adverse maternal or neonatal outcomes. It is a safe, economical, and practical alternative to epidural analgesia, especially in low-resource settings.

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