Comparison of sufentanil versus fentanyl with 0.125% bupivacaine for continuous labor epidural anesthesia. 1995

S J Kudialis, and R K Wirth

The search for an ideal combination of agents for labor epidural anesthesia has become a focus of current research studies. This study was performed to determine if a combination of sufentanil with bupivacaine would show superior analgesia and fewer side effects when compared with an equipotent combination of fentanyl with bupivacaine in continuous labor epidurals. After the approval of the Human Investigations Committee and written consent from the subjects, 54 parturients were assigned to receive one of two epidural drug combinations in a randomized double-blind design. Group S received a bolus of 10 mL of 2 micrograms/mL of sufentanil in 0.125% bupivacaine followed by an infusion of 0.4 micrograms/mL of sufentanil in 0.125% bupivacaine. Group F received a bolus of 10 mL of 10 micrograms/mL of fentanyl in 0.125% bupivacaine followed by an infusion of 2 micrograms/mL of fentanyl in 0.125% bupivacaine. Subsequent doses of 5 mL of 0.125% bupivacaine plain were given for inadequate analgesia per parturient request. Instrumentation included a visual analogue scale (VAS) for pain measurement and rating scales for side effects. Before the initial bolus, a baseline pain score was obtained. Pain scores and side effects were assessed at 30 minutes, 60 minutes, and hourly until delivery. Maternal satisfaction and apgar scores were recorded after delivery. There were no statistically significant differences found in VAS scores or requirement for epidural top-up injections between the two groups. Demographics, side effects, apgar scores, and maternal satisfaction scores were also comparable. Both sufentanil and fentanyl with bupivacaine provide comparably safe and satisfactory analgesia for labor epidural anesthesia.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D002045 Bupivacaine A widely used local anesthetic agent. 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide,Bupivacain Janapharm,Bupivacain-RPR,Bupivacaina Braun,Bupivacaine Anhydrous,Bupivacaine Carbonate,Bupivacaine Hydrochloride,Bupivacaine Monohydrochloride, Monohydrate,Buvacaina,Carbostesin,Dolanaest,Marcain,Marcaine,Sensorcaine,Svedocain Sin Vasoconstr,Bupivacain RPR
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D005260 Female Females
D005283 Fentanyl A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078) Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000767 Anesthesia, Epidural Procedure in which an anesthetic is injected into the epidural space. Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D000773 Anesthesia, Obstetrical A variety of anesthetic methods such as EPIDURAL ANESTHESIA used to control the pain of childbirth. Anesthesia, Gynecological,Anesthesia, Obstetric,Gynecologic Anesthesia,Paracervical Block,Anesthesia, Gynecologic,Block, Paracervical,Blocks, Paracervical,Gynecological Anesthesia,Obstetric Anesthesia,Obstetrical Anesthesia,Paracervical Blocks

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