INTRATHECAL LABOR ANALGESIA - CAN WE USE THE SAME MIXTURE AS IS USED EPIDURALLY

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.