A high rate of epidural analgesia with bupivacaine-sufentanil is consistent with a low rate of caesarean section and instrumental deliveries

Objective: To prospectively evaluate if a high rate of epidural analgesia ( EDA) with bupivacaine-sufentanil is consistent with a low rate of caesarean section, instrumental deliveries and dystocia and to evaluate maternal and fetal adverse effects of sufentanil. Study design: Populations-based prospective descriptive study. A change of EDA from bupivacaine to low dose bupivacaine-sufentanil at the delivery uni t of the hospital during 1993 resulted in a marked increase in the rate of EDA. The outcome from the study period (1994-1995) was compared to the outc ome during a reference period 1991-1992. Results: There were no significant differences in the incidence of caesarea n section and instrumental delivery for dystocia between the two periods (4 .4 and 4.6%). The overall incidence of caesarean section, 9.6% and instrume ntal deliveries, 6.4% during the study period was lower than or comparable to the national background data (11.1 and 6.8%, respectively) while the EDA rate was markedly higher 37.8 versus 21.9%. Conclusion: A high rate of EDA, using low dose bupivacaine and sufentanil i s consistent with a low rate of caesarean section and instrumental deliveri es. No apparent negative effects on the neonates or mothers were observed. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.