Journal article
Continuous Infusion Epidural Analgesia during Labor: A Randomized, Double-blind Comparison of 0.0625% Bupivacaine / 0.0002% Fentanyl Versus 0.125% Bupivacaine
Anesthesiology (Philadelphia), Vol.68(5), pp.754-759
05/1988
DOI: 10.1097/00000542-198709001-00443
PMID: 3285732
Abstract
The analgesic efficacy of the continuous epidural infusion of 0.0625% bupivacaine/0.0002% fentanyl was compared with the infusion of 0.125% bupivacaine alone in a randomized, double-blind study of nulliparous women. Each patient received, in sequence1)3 ml of 0.5% bupivacaine with 1:200,000 epinephrine; 2) 6 ml of study solution 1 (bupivacaine-fentanyl group0.125% bupivacaine/ 0.0008% fentanyl; bupivacaine-only group0.25% bupivacaine alone); and 3) a continuous epidural in fusion of study solution 2 at a rate of 12.5 ml/h (bupivacaine-fentanyl group0.0625% bupivacaine/0.0002% fentanyl; bupivacaine-only group0.125% bupivacaine alone). The epidural infusion was discontinued at full cervical dilatation, but patients who lacked perineal anesthesia received one or two 5-ml boluses of study solution 3 (bupivacaine-fentanyl group0.0625% bupivacaine alone; bupivacaine-only group0.125% bupivacaine alone). During the first stage of labor, 36 of 41 (88%) women in the bupivacaine-fentanyl group, and 37 of 39 (95%) women in the bupivacaine-only group, had analgesia of excellent or good quality (P = NS). During the second stage, 22 of 37 (59%) women in the bupivacaine-fentanyl group, and 23 of 35 (66%) women in the bupivacaine-only group, rated their analgesia as excellent or good (P = NS). Women in the bupivacaine-only group were more likely to have motor block at full cervical dilatation (P <.001). There was no significant difference between groups in duration of the second stage of labor, duration of pushing, position of the vertex before delivery, method of delivery, Apgar scores, or umbilical cord blood gas and acid-base values. The authors conclude that the continuous epidural infusion of 0.0625% bupivacaine/0.0002% fentanyl produced analgesia similar to that provided by the infusion of 0.125% bupivacaine alone. However, the less intense motor block experienced by women in the bupivacaine-fentanyl group did not significantly shorten the second stage or result in a greater frequency of spontaneous delivery.
Details
- Title: Subtitle
- Continuous Infusion Epidural Analgesia during Labor: A Randomized, Double-blind Comparison of 0.0625% Bupivacaine / 0.0002% Fentanyl Versus 0.125% Bupivacaine
- Creators
- David Chestnut - Assistant Professor of Anesthesia and Obstetrics and Gynecology. †Fellow in Obstetric Anesthesia. ‡Assistant Professor of Anesthesia. §Associate Professor of AnesthesiaCindy OwenJames BatesLars OstmanWon ChoiMarianne Geiger
- Resource Type
- Journal article
- Publication Details
- Anesthesiology (Philadelphia), Vol.68(5), pp.754-759
- DOI
- 10.1097/00000542-198709001-00443
- PMID
- 3285732
- NLM abbreviation
- Anesthesiology
- ISSN
- 0003-3022
- eISSN
- 1528-1175
- Publisher
- American Society of Anesthesiologists, Inc
- Language
- English
- Date published
- 05/1988
- Academic Unit
- Anesthesia
- Record Identifier
- 9984007189702771
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