Comparison among intrathecal fentanyl, meperidine, and sufentanil for labor analgesia.

This study compared the analgesic efficacy of intermittent injections of intrathecal fentanyl (10 micrograms), meperidine (10 mg), or sufentanil (5 micrograms) administered to 65 parturients during the first stage of labor. The groups did not differ in onset or duration of effective analgesia. The meperidine group, however, had significantly lower pain scores once cervical dilation progressed beyond 6 cm. Side effects included mild pruritus and nausea. After intrathecal drug injection, variable decelerations of the fetal heart rate increased in the fentanyl and meperidine groups. All neonates had a 5-min Apgar score of 7 or more. We conclude that intermittent intrathecal injections of fentanyl, meperidine, or sufentanil can provide adequate first-stage labor analgesia. Meperidine appears to provide more reliable analgesia as the first stage of labor progresses.

[1]  I. Power,et al.  The Effect of Fentanyl, Meperidine and Diamorphine on Nerve Conduction in Vitro , 1991, Regional Anesthesia & Pain Medicine.

[2]  K. Drasner,et al.  Cauda Equina Syndrome After Continuous Spinal Anesthesia , 1991, Anesthesia and analgesia.

[3]  S. Datta,et al.  Continuous microcatheter spinal anesthesia with subarachnoid meperidine for labor and delivery. , 1990, Anesthesia and analgesia.

[4]  B. Leighton,et al.  Intrathecal Narcotics for Labor Revisited: The Combination of Fentanyl and Morphine Intrathecally Provides Rapid Onset of Profound, Prolonged Analgesia , 1990, Anesthesia and analgesia.

[5]  C. Benedetti,et al.  Continuous subarachnoid analgesia in labour , 1990, The Lancet.

[6]  A. Ravalia,et al.  Respiratory depression and spinal opioids , 1989, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[7]  S. Datta,et al.  Effects of Fentanyl and Sufentanil on Peripheral Mammalian Nerves , 1987, Anesthesia and analgesia.

[8]  S. Sangarlangkarn,et al.  Meperidine as a Spinal Anesthetic Agent: A Comparison with Lidocaine‐Glucose , 1987, Anesthesia and analgesia.

[9]  T. Abboud,et al.  Intrathecal Administration of Hyperbaric Morphine for the Relief of Pain in Labour , 1984, British journal of anaesthesia.

[10]  A. Baraka,et al.  Intrathecal Injection of Morphine for Obstetric Analgesia , 1981, Anesthesiology.

[11]  K. O'driscoll.  Intrathecal morphine as sole analgesic during labour , 1980 .

[12]  D. Lambert,et al.  Continuous spinal anesthesia with a microcatheter technique: preliminary experience. , 1990, Anesthesia and analgesia.

[13]  Y. Shir.  Intrathecal Opioids, Potency and Lipophilicity. , 1989, Pain.