Butorphanol-bupivacaine versus Fentanyl-bupivacaine for Extradural Analgesia during Labour

Epidural injection of a combination of local anaesthetic drugs and opioids, is known to provide good analgesia for the first and second stages of labour, with minimal risk to the mother and the foetus.

64 pregnant women were allocated to one of two groups in a double blind, randomised, prospective study design. The first group (n=32) received 15ml of 0.1% bupivacaine with 0.1 nignil (-1) butorphanol (1.5mg) and the second group (n=32) received 15ml of 0.1% bupivacaine with 2μgml(-1) of fentanyl.

The times of onset and offset of analgesia were comparable. More patients of the butorphanol group were sedated but arousable. The patient satisfaction levels were good in both groups and APGAR scores were comparable.

Butorphanol and fentanyl when used in combination with 0.1% bupivacaine are effective, offer good patient satisfaction and are comparable in labour analgesia. Though more patients were sedated in the butorphanol group there was no maternal, foetal or neonatal adverse outcome and the drug appears to be a safe alternative to fentanyl in labour epidural analgesia.