Nl. Herman et al., Determination of the analgesic dose-response relationship for epidural fentanyl and sufentanil with bupivacaine 0.125% in laboring patients, J CLIN ANES, 10(8), 1998, pp. 670-677
Study Objective: To establish the analgesic effective doses as defined as a
visual analog pain scale (VAS) of at least 10 for 95% of parturients (ED95
) receiving either epidural fentanyl or sufentanil with bupivacaine 0.125%
for labor analgesia.
Design: Double-blind, randomized controlled study.
Setting: Two tertiary-care teaching hospitals.
Patients: 100 female patients, at full-term pregnancy, in active early labo
r (<5 cm carvical dilation) and requesting obstetric anesthesia services fo
r labor analgesia. Interventions: Patients were randomized and equally dist
ributed to receive one of ten epidural dosing regimens of bupivacaine 0.125
% alone ol with either fentanyl 25, 50, 75, or 100 mu g or sufentanil 5, 1
0, 15, 20, ol 25 mu g in a 10-ml bolus after a 3-ml test dose of bupivacain
e 0.25%.
Measurements and Main Results: VAS scores were obtained from each parturien
t using a 10-cm plastic VAS slide rule at times 0, 1, 5, 10, 15, 20, 25, an
d 30 minutes, and then again when the patient requested additional analgesi
a. Analgesia duration and demographic and obstetric data also were obtained
. Using a log-probit dose-responce analysis, analgesic success as defined a
s a VAS of at least 10 with each opioid dose was plotted and an ED, value o
f 8 mu g and 50 mu g was Established for sufentanil and fetanyl, respective
ly, in bupivacaine 0.125 %. No statistical difference was detected for anal
gesic duration or incidence of side effects between analgesic groups.
Conclusions: Epidural analgesia with fentanyl and sufentanil in bupivacaine
0.125 % behaves in a close-response fashion allowing for the determination
of equipotent dose of each. (C) 1998 by Elsevier Science Inc.