Two doses of intrathecal sufentanil (2.5 and 5 mu g) combined with bupivacaine and epinephrine for labor analgesia

In this study, we evaluated the effect of two doses of intrathecal sufentan il combined with bupivacaine and epinephrine on the incidence of pruritus a nd on the duration and quality of analgesia. One hundred five parturients w ere enrolled in this randomized, double-blinded, placebo-controlled study. They received either intrathecal 1.25 mg bupivacaine and 25 mu g epinephrin e (control group); 1.25 mg bupivacaine, 25 pg epinephrine, and 2.5 mu g suf entanil (2.5-mu g group); or 1.25 mg bupivacaine, 25 mu g epinephrine, and 5 mu g (5-mu g group). Pain relief was assessed 10 min after injection, and pruritus was recorded at 30 min by a blinded observer. The study ended whe n the parturients requested further analgesia. There were no demographic di fferences among groups. Ninety of 103 parturients achieved complete pain re lief with the initial dose, 11 patients in the control group (P < 0.004, co ntrol versus both sufentanil groups), and 2 patients in the 2.5-mu g group needed a supplemental epidural bupivacaine. Pruritus was absent in the cont rol group (P < 0.0001, control versus both sufentanil groups), whereas it w as present in 36% of the 2.5-mu g group and in 66% of the 5-mu g group (P = 0.015, 2.5-mu g versus 5-mu g group). The mean duration of analgesia was s imilar in patients receiving sufentanil (2.5-mu g group: 133 +/- 55 min; 5- mu g group: 142 +/- 52 min) but was significantly higher than the control g roup (56 +/- 32 min). Reducing the sufentanil dose from 5 mu g to 2.5 mu g when combined with bupivacaine and epinephrine, decreases the incidence of pruritus without impeding the quality or duration of analgesia. Implication s: We evaluated two different doses of intrathecal sufentanil combined with bupivacaine and epinephrine for labor analgesia. Sufentanil 2.5 mu g offer ed an advantage over sufentanil 5 mu g because, while providing the same qu ality and duration of analgesia, it was associated with a reduced incidence of pruritus.