Manouchehrian Nahid, Rabiei Soghra, Moradi Abbas, Lakpur Zahra
Department of Anesthesiology, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Obstetrics and Gynecology, Fatemi Medical Center, Hamadan University of Medical Sciences, Hamadan, Iran.
Anesth Pain Med. 2020 Jun 28;10(3):e99843. doi: 10.5812/aapm.99843. eCollection 2020 Jun.
Labor pain is a severe pain, and intrathecal opioid injection is one of the analgesia methods to reduce it.
We assessed the effects of intrathecal Fentanyl and Sufentanil on the onset, duration, and quality of analgesia for labor analgesia.
In this double-blind, randomized clinical trial, 54 healthy nulliparous women 18 - 45 years in the active phase of labor who were requesting labor analgesia were enrolled in two groups fentanyl (F) and sufentanil (S). Patients received 75 µg fentanyl or 7.5 µg sufentanil intrathecally in the fentanyl group (n = 27) and the sufentanil group (n = 27), respectively. Pain relief, onset, duration of analgesia, hemodynamic parameters, patients' satisfaction, and neonatal Apgar score were assessed in this study. Data were analyzed by using SPSS16.
There were no significant differences between the groups in terms of demographic and hemodynamic parameters. The onset time of analgesia was 5.6 ± 4.3 and 3.6 ± 2.1 minutes, in the sufentanil and fentanyl groups, respectively (P = 0.037). The duration of analgesia was higher in patients who received sufentanil than those who received fentanyl (113 ± 45 vs. 103 ± 22 minutes (P = 0.629)). The pain score in the Fentanyl group was significantly lower at 5, 10, and 15 minutes after spinal analgesia (P < 0.05). The sedation score at 1 and 5 minutes was significantly higher in the fentanyl group than the sufentanil group (P < 0.05). The frequency and severity of pruritus and satisfaction rate in the fentanyl group were significantly higher than the sufentanil group.
Intrathecal fentanyl and sufentanil have a similar analgesic effect on labor. Fentanyl is associated with a faster onset of analgesia and more satisfaction, while sufentanil has longer analgesia.
分娩疼痛是一种剧痛，鞘内注射阿片类药物是减轻疼痛的镇痛方法之一。
我们评估了鞘内注射芬太尼和舒芬太尼对分娩镇痛的起效时间、持续时间及镇痛质量的影响。
在这项双盲、随机临床试验中，54名年龄在18 - 45岁、处于分娩活跃期且要求分娩镇痛的健康初产妇被纳入芬太尼（F）组和舒芬太尼（S）组。芬太尼组（n = 27）和舒芬太尼组（n = 27）的患者分别接受鞘内注射75μg芬太尼或7.5μg舒芬太尼。本研究评估了疼痛缓解情况、起效时间、镇痛持续时间、血流动力学参数、患者满意度及新生儿阿氏评分。数据采用SPSS16进行分析。
两组在人口统计学和血流动力学参数方面无显著差异。舒芬太尼组和芬太尼组的镇痛起效时间分别为5.6±4.3分钟和3.6±2.1分钟（P = 0.037）。接受舒芬太尼的患者镇痛持续时间长于接受芬太尼的患者（113±45分钟 vs. 103±22分钟，P = 0.629）。脊髓镇痛后5分钟、10分钟和15分钟时，芬太尼组的疼痛评分显著更低（P < 0.05）。芬太尼组在1分钟和5分钟时的镇静评分显著高于舒芬太尼组（P < 0.05）。芬太尼组瘙痒的频率和严重程度以及满意度均显著高于舒芬太尼组。
鞘内注射芬太尼和舒芬太尼对分娩具有相似的镇痛效果。芬太尼镇痛起效更快且满意度更高，而舒芬太尼镇痛持续时间更长。
