COMBINED SPINAL-EPIDURAL ANALGESIA IN LAB OR - PROLONGATION BY ADDITION OF A MINIDOSE OF CLONIDINE TO SUFENTANIL - PRELIMINARY-STUDY

The effect of adding a minidose of clonidine to intrathecal sufentanil during the early first stage of a painful labour was evalluated in th is preliminary open-label, non-randomised trial. Group 1 received sufe ntanil 5 mu g + clonidine 30 mu g intrathecally (n = 10) and group 2 o nly intrathecal sufentanil 5 mu g (n = 1 1). The two groups were not s tatistically different regard-ing age, weight, height, primiparity (67 vs 50%), oxytocin use (37 vs 60%), initial cervical dilation (m +/- D S : 2.9 +/- 1.1 vs 2.9 +/- 1 cm) and VAS pain scores (70 +/- 14 vs 68 +/- 19 mm). In group 1, analgesia was markedly prolonged with a reduce d variability in duration. 146 +/- 27 min vs 95 +/- 44 min, (P = 0.006 ). VAS pain scores were: 14 +/- 20 vs 19 +/- 13, 1 +/- 3 vs 9 +/- 12, 0 vs 5 +/- 7, 48 +/- 12 vs 65 +/- 15, five and fifteen minutes after i ntrathecal injection, during maximum efficacy, and at the time additio nal analgesia was required, in group 1 and group 2, respectively. Anal gesia evaluated with the VAS pain scores was better in group 1 compare d with group 2 (P = 0.02) and decreased somewhat slower. Side effects, such as hypotension, pruritus and sedation, were not statistically di fferent between groups. Nausea and motor blockade did not occur. In co nclusion, the addition of a minidose (30 mu g) of clonidine to sufenta nil 5 mu g given intrathecally seems to potentiate markedly the analge sia obtained during the early first stage of labour.