COMPARISON OF 3 DIFFERENT DOSES OF INTRATHECAL FENTANYL AND SUFENTANIL FOR LABOR ANALGESIA

Study Objective: To compare the duration of analgesia and incidence of side effects of three doses of intrathecal fentanyl (25 mu g, 37.5 mu g, 50 mu g) with three doses of intrathecal sufentanil (5 mu g, 10 mu g, 15 mu g). Design: Randomized, double-blind study. Setting: Labor s uite of the Hospital of the University of Pennsylvania Patients: 60 AS A Physical status I and II parturients in active labor who requested a nalgesia. Interventions: Patients received one of the six doses of opi oid diluted with normal saline to achieve a volume of 1.5 ml intrathec ally. Measurements and Main Results: Duration of analgesia, contractio n pain, degree of pruritus maternal blood pressure, maternal heart rat e, fetal heart rate, Apgar scores, and neurologic and adaptive capacit y scores were measured. There was no statistical difference among the doses of fentanyl in duration of analgesia. In addition, there was no statistical difference among the doses of sufentanil. The durations of analgesia for all doses of sufentanil were statistically longer than that for all doses of fentanyl. There was no difference among all the groups for maximal pruritus score. The duration of pruritus did not di ffer among doses of fentanyl or sufentanil; the duration of pruritus w as significantly longer for sufentanil. All groups had a decrease in b lood pressure. There was no difference among the groups in regard to t he effect on the systolic or diastolic blood pressure. Conclusions: In trathecal sufentanil produced analgesia of longer duration than fentan yl for all doses studied The duration of pruritus with sufentanil was also longer. (C) 1998 by Elsevier Science Inc.