Abstract
Ninety-five healthy nulliparous women, ASA physical status I–II with an uncomplicated pregnancy and single fetus in vertex position were given lumbar epidural analgesia. Patients in Group A (n = 35) received bupivacaine 0.125 per cent with epinephrine 1800.000; Groups B (n = 30) and C (n = 30) received the same agents as Group A but with the addition to the initial dose of 50 or 100 µg of fentanyl respectively. All patients were evaluated for duration and quality of analgesia, duration of labour, method of delivery and total dose of bupivacaine used. The addition of either 50 or 100 µg of fentanyl resulted in longer duration of analgesia (93 ± 9 min and 106 ± 8 min respectively vs 55 ± 7) and reduced bupivacaine total doses (64 ± 0.03 and 55 ± 1.5 respectively vs 109.5 ± 1.3). Only the addition of 100 µg of fentanyl improved significantly the quality of analgesia (43.3 per cent of excellent scores vs 6.6 per cent in Group B and 5.7 per cent in Group A). Addition of fentanyl did not affect the duration of labour, the method of delivery and the neonatal neurobehaviour scores.
Résumé
Quatre-vingt-quinze femmes nullipares en bonne santé ASA classe I–II lors ďune grossesse non-compliquée ont reçu une analgésie épidurale lombaire. Les patientes du groupe A(n = 35) ont reçu de la bupivacaïne 0.125 pour cent avec épinéphrine 1:800,000: les patientes du groupe B (n = 30) et C (n = 30) ont reçu les mêmes médicaments que celles du groupe A mais avec ľaddition ďune dose initiale de 50 ou 100 µg de fentanyl respectivement. Les patientes furent évaluées pour la durée et la qualité de ľanalgésie, la durée du travail, la méthode ďaccouchement et la dose totale de bupivacaïne utilisée. Ľaddition de 50 et 100 µg de fentanyl a prolongé la durée de ľanalgésie (93 ± 9 minutes et 106 ± 8 minutes respectivement versus 55 ± 7) et a réduit les doses totales de bupivacaïne (64 ± 0.003 et 55 ± 1.5 respectivement versus 109.5 ± 1.3). Seule ľaddition de 100 µg de fentanyl a amélioré significativement la qualité de ľanalgésie (43.3 pour cent des scores excellents versus 6.6 pour cent dans le groupe B et 5.7 pour cent dans le groupe A). Ľaddition de fentanyl n’a pas affecté la durée du travail, et la méthode de ľaccouchement et le score néonatal.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Youngstrom P, Eastwood D, Patel H, Bhatia R, Cowan R, Sutheimeer C, Epidural fentanyl and bupivacaine in labor: double blind study. Anesthesiology 1984; 61: A414.
Desprats R, Mandry J, Granjean H, Amar B, Pontonnier G, Lareng L. Analgésie peridurale au cours du travail: étude comparative de ľassociation fentanyl-marcaine et de la marcaine seule. J Gyn Obstet Biol Repr 1983; 12: 901–5.
Justins DM, Francis D, Houlton PG, Reynolds F. A controlled trial of extradural fentanyl in labour. Br J Anaesth 1982; 54: 409–14.
Carrie IES, O’Sullivan GM, Leegobin R. Epidural fentanyl in labour. Anaesthesia 1981; 36: 965–9.
Bleyaert A, Soetens M, Vaes L, Van Steenberge A, Van der Donck A. Bupivacaine 0.125% in obstetric epidural analgesia: experience in three thousand cases. Anesthesiology 1979; 51: 435–8.
Knepp NB, Cheer TG, Gutshe BB. Bupivacaine: continuous infusion epidural analgesia for labor. Anesthesiology 1983; 59: A407.
Van Zundert A, Vanderaa PP, Van der Donck A, Meeuwis H, Vaes L. Motor blockade expulsion times and instrumental deliveries associated with epidural analgesia for vaginal delivery. Obstet Anesth Digest 1984; 4: 152–6.
Gauthier et Lafayer. Precis d’anesthesie loco-regionale. Masson (Ed.) Paris, 1985.
Bromage PR. Epidural analgesia. Philadelphia: WB Saunders, 1978 p. 144.
Amiel-Tison C, Barrier G, Shnider M, Levinson G, Huges S, Stefani, S. A new neurologic and adaptive capacity scoring system for evaluating obstetric medications in full-term newborns. Anesthesiology 1982; 56: 340–50.
Reynolds F. A comparison of the potential toxicity of bupivacaine, lidocaine and mepivacaine during epidural blockade for surgery. Br J Anaesth 1971; 43: 567–70.
Wiklund L, Berlin-Wahlen A. Splanchnic elimination and systemic toxicity of bupivacaine and etidocaine in man. Acta Anaesthesiol Scand 1977; 21: 521–8.
Morishima HO, Pedersen H, Finster M et al. Bupivacaine toxicity in pregnant and nonpregnant ewes. Anesthesiology 1985; 63: 134–9.
Liu P, Feldman HS, Giosi R, Patterson MK, Covino BG. Comparative CNS toxicity of lidocaine, etidocaine, bupivacaine and tetracaine in awake dogs following rapid IV administration. Anesth Analg 1983; 62: 375–9.
Lam AM, Knill RL, Thompson JL, Clement GP, Varkey GP, Spoel WE. Epidural fentanyl does not cause delayed respiratory depression. Can Anaesth Soc J 1983; 30: S78–9.
Bromage PR, Camporesi EM, Durant PAC, Nielsen CH. Influence of epinephrine as an adjuvant to epidural morphine. Anesthesiology 1983; 58: 257–62.
Hanson AL, Hanson B. Continuous mini-infusion of bupivacaine into the epidural space during labor. Regional Anesth 1985; 10: 139–44.
Baraka A, Maktaby M, Noueihid R. Epidural meperidine-bupivacaine for obstetric analgesia. Anesth Analg 1982; 61: 652–6.
Cohen SE, Tan S, Albright GA, Halpern J. Epidural fentanyl/bupivacaine combinations for labor analgesia: effect of varing dosages. Anesthesiology 1986; 65: A368.
Muller H, Borner U, Stoianov M, Hempelmen G. The perioperative use of epidural opiate.In: Yaksh TL, Muller H, Henquist A. Anesthesiology and Intensive Care Medicine: Spinal opiate analgesia. Heidelberg, Springer Verlag, 1982; p. 67.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Celleno, D., Capogna, G. Epidural fentanyl plus bupivacaine 0.125 per cent for labour: analgesic effects. Can J Anaesth 35, 375–378 (1988). https://doi.org/10.1007/BF03010859
Issue Date:
DOI: https://doi.org/10.1007/BF03010859