Comparison of epidural lidocaine and fentanyl to intrathecal sufentanil for analgesia in early labour

A randomized, double-blind study was undertaken comparing an epidural test dose of lidocaine followed by 100 mu g fentanyl (E-LE, n = 19) to combined spinal epidural sufentanil 10 mu g (CSE-S, n = 21) in low risk women in ear ly labour. The primary outcome measured was the duration of analgesia; seco ndary outcomes included the quality of analgesia, incidence and severity of pruritus, lower limb motor blockade, and the ability to ambulate. A P <0.0 5 was considered statistically significant, Baseline demographic characteri stics, including parity, were similar between groups. CSE-S provided analge sia of longer duration than E-LF (126 +/- 61 min versus 83 +/- 37 min, P <0 .01). Visual analog scores (VAS) for pain were higher with E-LF throughout the study period (P <0.05) although patients in both groups had clinically acceptable analgesia. The VAS for pruritus were higher ill the CSE-S group (P <0.05) but no patient requested treatment for pruritus. Mild motor weakn ess was more frequent in the E-LF group (5/19 versus 0/21, P <0.05) and few er patients in the E-LF group met criteria for ambulation (13/19 versus 20/ 21, P <0.05). While both E-LF and CSE-S provide effective analgesia for wom en in early labour, the more rapid onset of analgesia, lower VAS pain score s, longer duration of action and lesser impact on ability to ambulate sugge st advantages of CSE-S over E-LE (C) 1999 Harcourt Publishers Ltd.