Comparison of fentanyl and sufentanil in combination with bupivacaine for patient-controlled epidural analgesia during labor

被引:47
作者
Le Guen, H [1 ]
Roy, D [1 ]
Branger, B [1 ]
Ecoffey, C [1 ]
机构
[1] Univ Rennes 1, Dept Anesthesiol, F-35014 Rennes, France
关键词
anesthesia; obstetric; anesthetic techniques : patient-controlled epidural analgesia; bupivacaine; fentanyl; sufentanil;
D O I
10.1016/S0952-8180(01)00221-5
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Study Objective: To compare the efficacy of fentanyl plus bupivacaine with sufentanil plus bupivacaine for treatment of pain during labor and delivery using patient-controlled epidural analgesia (PCEA). Design: Prospective, double-blind, clinical investigation. Setting: University-affiliated hospital. Patients: 226 ASA physical status I and II laboring patients. Interventions: Patients were randomized to receive 0.125% bupivacaine with fentanyl (2 mu .ml(-1)) or 0.125% bupivacaine with sufentanil (0.25 mug.ml(-1)) through PCEA. Measurements: Maternal analgesia assessed by visual analog scale was recorded before epidural block, 1 and 3 hours after epidural block, at full cervical dilation, and at delivery. Motor blockade assessed by Bromage scale was recorded at delivery. Main results: Nine patients in group fentanyl, and I I in group sufentanil were excluded from the study. Overall analgesia was good and no difference was observed between the two groups. Total boluses of 4 mL, bupivacaine-opioid administered and the number of supplementary top-up injections of 5 mL, 0.25 % bupivacaine were similar in both groups. In group sufentanil, motor blockade and pruritus were significantly lower than in group fentanyl. Nausea was not recorded in any patients. Mode of delivery was similar in both groups, i.e., cesarean section, vacuum or forceps, or spontaneous vaginal delivery. No difference was observed in Apgar scores. Conclusions: Sufentanil is preferable to fentanyl during bupivacaine PCEA as there is less incidence of motor blockade and pruritus. (C) 2001 by Elsevier Science Inc.
引用
收藏
页码:98 / 102
页数:5
相关论文
共 26 条
[1]   EPIDURAL ANALGESIA DURING LABOR - CONTINUOUS-INFUSION OR PATIENT-CONTROLLED ADMINISTRATION [J].
BENHAMOU, D .
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 1995, 59 :S55-S56
[2]   Optimal labour analgesia 1996 [J].
Breen, TW .
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1996, 43 (04) :327-&
[3]   QUALITY OF EPIDURAL BLOCKADE .1. INFLUENCE OF PHYSICAL FACTORS [J].
BROMAGE, PR ;
BURFOOT, MF ;
PETTIGREW, RT ;
CROWELL, DE .
BRITISH JOURNAL OF ANAESTHESIA, 1964, 36 (06) :342-&
[4]   Epidural analgesia for labour and delivery: Fentanyl or sufentanil? [J].
Cohen, S ;
Amar, D ;
Pantuck, CB ;
Pantuck, EJ ;
Goodman, EJ ;
Leung, DHY .
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1996, 43 (04) :341-346
[5]  
CROWHURST JA, 1994, INT ANESTHESIOL CLIN, V32, P45
[6]   PATIENT-CONTROLLED EPIDURAL ANALGESIA IN OBSTETRIC ANESTHETIC PRACTICE [J].
CURRY, PD ;
PACSOO, C ;
HEAP, DG .
PAIN, 1994, 57 (01) :125-127
[7]  
FERRANTE FM, 1991, ANESTH ANALG, V73, P547
[8]  
FERRANTE FM, 1994, ANESTH ANALG, V79, P80
[9]   PATIENT-CONTROLLED EPIDURAL ANALGESIA IN LABOR - VARYING BOLUS DOSE AND LOCKOUT INTERVAL [J].
GAMBLING, DR ;
HUBER, CJ ;
BERKOWITZ, J ;
HOWELL, P ;
SWENERTON, JE ;
ROSS, PLE ;
CROCHETIERE, CT ;
PAVY, TJG .
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE, 1993, 40 (03) :211-217
[10]  
GAMBLING DR, 1990, ANESTH ANALG, V70, P256