[Peridural analgesia with fentanyl--an alternative to control of labor pain]

Modern obstetrics should include not only an optimal labour monitoring but also an adequate pain relief during delivery. Due to the discovery of specific opiate receptors, for example in the substantia gelatinosa of the posterior horn in the spinal cord and the proof of direct pain-modifying effects on spinal level, new ways of the therapy of pain have been developed. The analysis was made with 40 parturients, who had decided for an epidural analgesia. They were given 0.1 mg fentanyl epidurally at a cervical dilatation of 3 to 5 cm and regular uterine contractions. The registrated onset time of fentanyl was between 6 and 15 minutes. A fentanyl dose of 0.1 mg applied epidurally proved to be sufficient for all parturients for the alleviation of pain in the period of dilatation. The interval without pain amounted to 130 mins. The motoricity was not impaired by the peridural application of fentanyl, because the parturient was able to be mobilized under continuous telemetric monitoring including telemetric management of the profile of the uterine activity. The period of the active and latent phases as well as the total delivery time was within the desirable ranges. An impairment of the general condition, e.g. vomiting, nausea or pruritus, was not noticed. There were no circulatory disturbances either. After the application of fentanyl the cardiotocograms remained uninfluenced in all parameters. All parturients declared that they had a positive birth experience under this kind of obstetric analgesia and that they would decide for this method again in case of a further delivery.