Epidural infusions for nulliparous women in labour. A randomised double-blind comparison of fentanyl/bupivacaine and sufentanil/bupivacaine.

Abstract

Sixty nulliparous women received epidural infusions in labour of 0.0625% bupivacaine containing either 2.5 micrograms.ml-1 of fentanyl or 0.25 micrograms.ml-1 of sufentanil, each starting at 12 ml.h-1. The duration of each stage of labour did not differ significantly between the groups nor did the mode of delivery. The quality of analgesia in the first and second stages of labour and at delivery was similar in the two groups and there were no significant differences in the bupivacaine dose requirements. In the fentanyl group, 90% of women required one or no top-ups compared with 87% in the sufentanil group. Five women in the fentanyl group and four in the sufentanil group developed motor blockade, limited to movement of the hip only. Six women (20%) in each group reported pruritus. There were no significant differences in Apgar scores, umbilical cord blood pH levels or neurologic and adaptive capacity scores at 2 or 24 h. Satisfaction with first and second stage analgesia was high with no differences between the groups. There were no significant differences in the incidence of postnatal symptoms with 52% of women reporting perineal pain and 45% localised backache.