Kalra Sumit, Saraswat Namita, Agnihotri G S
Department of Anaesthesia, Lady Hardinge Medical College, New Delhi, India.
Saudi J Anaesth. 2010 Sep;4(3):178-81. doi: 10.4103/1658-354X.71569.
A study to compare the efficacy between fentanyl and sufentanil combined with low concentration (0.0625%) of bupivacaine for epidural labor analgesia in laboring women
Fifty full term parturients received an initial bolus dose of a 10 ml solution containing 0.125% bupivacaine. The patients were randomly divided into two: group F received 0.0625% bupivacaine with 2.5 mcg/ml fentanyl and group S received 0.0625% bupivacaine with 0.25 mcg/ml sufentanil. Verbal analogue pain scores, need of supplementary/rescue boluses dose of bupivacaine consumed, mode of delivery, maternal satisfaction, and neonatal Apgar scores were recorded. No significant difference was observed between both groups.
Both the groups provided equivalent labor analgesia and maternal satisfaction. The chances of cesarean delivery were also not increased in any group. No difference in the cephalad extent of sensory analgesia, motor block or neonatal Apgar score were observed. Although mean pain scores throughout the labor and delivery were similar in both groups, more patients in fentanyl group required supplementary boluses though not statistically significant.
We conclude that both 0.0625% bupivacaine-fentanyl (2.5 μg/ml) and 0.0625% bupivacaine-sufentanil (0.25 μg/ml) were equally effective by continuous epidural infusion in providing labor analgesia with hemodynamic stability achieving equivalent maternal satisfaction without serious maternal or fetal side effects. We found that sufentanil was 10 times more potent than fentanyl as an analgesic for continuous epidural labor analgesia.
比较芬太尼与舒芬太尼联合低浓度（0.0625%）布比卡因用于分娩期妇女硬膜外分娩镇痛的效果
50例足月产妇接受初始剂量为10ml含0.125%布比卡因的溶液推注。患者随机分为两组：F组接受含2.5μg/ml芬太尼的0.0625%布比卡因，S组接受含0.25μg/ml舒芬太尼的0.0625%布比卡因。记录视觉模拟疼痛评分、补充/追加布比卡因推注剂量的需求、分娩方式、产妇满意度及新生儿阿氏评分。两组间未观察到显著差异。
两组提供的分娩镇痛效果及产妇满意度相当。两组剖宫产的几率均未增加。感觉镇痛的头端范围、运动阻滞或新生儿阿氏评分均无差异。尽管两组在整个分娩过程中的平均疼痛评分相似，但芬太尼组更多患者需要追加推注，不过差异无统计学意义。
我们得出结论，0.0625%布比卡因 - 芬太尼（2.5μg/ml）和0.0625%布比卡因 - 舒芬太尼（0.25μg/ml）通过持续硬膜外输注在提供分娩镇痛方面同样有效，血流动力学稳定，产妇满意度相当，且无严重的母婴副作用。我们发现，作为连续硬膜外分娩镇痛的镇痛药，舒芬太尼的效力是芬太尼的10倍。
