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Subarachnoid labor analgesia. Fentanyl and morphine versus sufentanil and morphine
V A Arkoosh1, S J Sharkey, M C Norris
1Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Background And Objectives:
To compare the duration of pain relief and incidence of side effects using two subarachnoid administered drug combinations for labor analgesia: fentanyl 25 micrograms with morphine 0.25 mg or sufentanil 10 micrograms with morphine 0.25 mg.
Methods:
Thirty healthy term primagravid patients with cervical dilation < or = 5 cm consented to participate in this prospective, randomized, double-blind study. Patients received the assigned drug combination subarachnoid with simultaneous epidural catheter placement using a double needle technique. The authors recorded blood pressure and patient's rated pain, nausea, and pruritus using 10-cm visual analog scales at 0, 5, 10, 15, 20, 25, 30, and every 30 minutes until the patient requested additional analgesia.
Results:
The onset of analgesia was rapid in both groups. The mean duration of analgesia was similar; 114 +/- 55 minutes in the fentanyl and morphine group and 134 +/- 79 minutes in the sufentanil and morphine group. The sufentanil and morphine group experienced more severe pruritus (P = .015).
Conclusions:
Both fentanyl and morphine and sufentanil and morphine provide adequate labor analgesia for about 2 hours. Patients who receive sufentanil experience more severe pruritus.