DOUBLE-BLIND COMPARISON OF INTRAVENOUS BUTORPHANOL (STADOL) AND FENTANYL (SUBLIMAZE) FOR ANALGESIA DURING LABOR

OBJECTIVE: Our purpose was to compare the analgesic properties, effect on labor, and maternal-fetal side effects of intravenous butorphanol and fentanyl. STUDY DESIGN: One hundred patients with uncomplicated te rm pregnancies were enrolled during early active labor. Each patient r eceived standard doses of either fentanyl (50 to 100 mu g) or butorpha nol (1 to 2 mg) hourly on request in a double-blind manner. Pain was s cored independently by the nurse and patient with a 10-point visual an alog scale. Categoric and measurement data were collected for comparis on of the effects on uterine activity, maternal and fetal well-being, and neonatal outcomes. RESULTS: The fentanyl (n = 50) and butorphanol (n = 50) groups were identical with respect to maternal age, race, par ity, and weight. Greater improvement in pain relief was found after th e first dose of butorphanol than after fentanyl (p < 0.05). When fenta nyl was given, either more doses were necessary (3.2 +/- 1.3 vs 2.1 +/ - 1.1, p < 0.01) or epidural analgesia was requested more often (16%, 32% vs 9%, 18%, p < 0.05). Uterine contraction patterns for the first hour after dosing were unchanged, and the duration of the first and se cond stages of labor were not different between the two groups. No dif ferences in maternal or newborn adverse effects were observed. CONCLUS IONS: Both drugs were equally safe and without effect on active labor. Butorphanol provided better initial analgesia than fentanyl with fewe r patient requests for more medication or epidural analgesia.