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OBSTETRIC ANESTHESIA

Comparison of Epidural Fentanyl Versus Epidural Sufentanil for Analgesia in Ambulatory Patients in Early Labor

Department of Anesthesiology, Baystate Medical Center, Springfield, Massachusetts

Address correspondence and reprint requests to Neil Roy Connelly, MD, Department of Anesthesiology, Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199. Address e-mail to Neil.Roy.Connelly{at}bhs.org

Epidural sufentanil, after a lidocaine and epinephrine test dose, provides adequate analgesia and allows for ambulation during early labor. Epidural fentanyl has not been evaluated in this setting. The current study was designed to determine whether there is an analgesic difference between epidural fentanyl and epidural sufentanil in laboring patients. Forty-six laboring nulliparous women, at <5-cm cervical dilation, who requested epidural analgesia were enrolled. After a 3-mL test dose of lidocaine with epinephrine, patients were randomized to receive either sufentanil 20 µg or fentanyl 100 µg. After administration of the analgesic, pain scores and side effects were recorded for each patient at 5, 10, 15, 20, and 30 min and every 30 min thereafter, by an observer blinded to the technique used. There were no demographic differences between the two groups. Pain relief was rapid for all patients. The mean durations of analgesia were similar between the sufentanil group (138 ± 50 min) and the fentanyl group (124 ± 42 min). Side effects were similar between the two groups. In early laboring patients, epidural fentanyl 100 µg, after a lidocaine and epinephrine test dose, provides analgesia comparable to that of sufentanil 20 µg.

Implications: In early laboring patients, epidural fentanyl 100 µg, after a lidocaine and epinephrine test dose, provides analgesia comparable to that of sufentanil 20 µg.

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