M. Vercauteren et al., INTRATHECAL LABOR ANALGESIA - CAN WE USE THE SAME MIXTURE AS IS USED EPIDURALLY, International journal of obstetric anesthesia, 6(4), 1997, pp. 242-246
In a randomized double-blind study, three groups of 25 term parturient
s received one of the following intrathecal drugs or combinations for
relief of labor pain: sufentanil 7.5 mu g (1.5 mi), sufentanil 5 mu g
+ bupivacaine 1 mg (1.5 mi) or the combination bupivacaine 1.75 mg, su
fentanil 1.05 mu g and epinephrine 1.75 mu g, that is 1.5 mi of our st
andard epidural mixture. After the intrathecal injection, patients rec
eived a peridural catheter for supplementation of analgesia. Onset and
duration of the three regimens were similar. Analgesia lasted for app
roximately 95-115 minutes which was similar to durations obtained with
the subsequent epidural top-ups. Pruritus was observed significantly
less frequently in the group treated intrathecally with the epidural m
ixture. The incidence of other maternal side-effects was extremely low
and not different among the groups. Instrumental delivery, Apgar scor
es and umbilical blood gases were identical. More cardiotocographic ch
anges were observed in the plain sufentanil group but this was not rel
ated to neonatal outcome. It was concluded that intrathecal injection
of the standard epidural mixture offers effective and long-lasting ana
lgesia. This may avoid side-effects and complications, manipulations o
f drugs with the risk for contamination, spilling of drugs and loss of
time.