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Comparison Among Intrathecal Fentanyl, Meperidine, and Sufentanil for Labor Analgesia

Departments of Anesthesiology and Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania

This study compared the analgesic efficacy of intermittent injections of intrathecal fentanyl (10 µg), meperidine (10 mg), or sufentanil (5 µg) administered to 65 parturients during the first stage of labor. The groups did not differ in onset or duration of effective analgesia. The meperidine group, however, had significantly lower pain scores once cervical dilation progressed beyond 6 cm. Side effects included mild pruritus and nausea. After intrathecal drug injection, variable decelerations of the fetal heart rate increased in the fentanyl and meperidine groups. All neonates had a 5-min Apgar score of 7 or more. We conclude that intermittent intrathecal injections of fentanyl, meperidine, or sufentanil can provide adequate first-stage labor analgesia. Meperidine appears to provide more reliable analgesia as the first stage of labor progresses. (Anesth Analg 1992;75:734–9)

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