Combined Spinal- Epidural in Labor Analgesia: Comparison of Fentanyl Bupivacaine Mixture versus Sufentanil - Bupivacaine Mixture
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 5
Abstract
Background: We conducted a prospective randomized control trial on labor analgesia involving 30 parturient. We evaluated and compared the efficacy of bupivacaine fentanyl (BF) and bupivacaine-sufentanil (BS) administered in combined spinal-epidural for labor analgesia. The time required to achieve fitness for ambulation after intrathecal drug administration was also assessed. 30 parturients who voluntarily opted for labor analgesia were randomly divided into two groups to receive either BF or BS. Methods: The intrathecal drug solution was bupivacaine (2.5 mg) with either fentanyl (25 μg) or sufentanil (5 μg). This was followed by continuous infusion of 10 ml/h 0.0625% bupivacaine with either fentanyl 2.5 μg/ml or sufentanil 0.5 μg/ml when the intrathecal drug effect weared off. Ambulation was assessed at 30, 45, and 60 min after intrathecal drug administration. Results: Demographic data and labor characteristics were comparable between the groups, all parturient in both the group had rapid onset of analgesia (3.25 ± 0.29 min in group BF vs. 3.23 ± 0.19 min in group BS). There was motor block following intrathecal drug administration (Modified Bromage score of 1 or 2) in all parturients. The duration of analgesia following intrathecal drug administration was comparable between the two groups (89.29:l:15.78 min in group BF vs. 87.60 ± 14.47 min in group BS). The epidural drug solution was started when visual analog scale (VAS) pain score exceeded 40. After negative aspiration, bolus of 10 ml of drug solution was given in increments. VAS score, maternal heart rate (HR), blood pressure, saturation, and fetal HR were observed at 5, 10, 20, and 30 min after intrathecal drug administration and every 30 min until epidural was initiated. The duration of the first stage of labor was 218.56 ± 69.56 min in group BF and 211.56 ± 58.96 min in group BS. The duration of the second stage of labor was 54.90 ± 32.27 min in group BF and 51.78 ± 16.71 min in group BS. Conclusion: Both the combination provided equally efficacious analgesia. The numbers of breakthrough pain episodes were comparable between the groups. The VAS score was comparable between the groups at all intervals during epidural drug infusion. The duration for which epidural drug was administered and the amount of bupivacaine consumed was similar between the two groups. 11 parturient in group BF and 13 in parturient in group BS rated their pain relief as excellent
Authors and Affiliations
S Vijay Anand, T Kabila Rajee, Saranya Nagalingam
Keywords
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