Efficacy and Safety of Sufentanil and Pethidine in Spinal Anesthesia for Painless Labor

Abstract

Purpose:

Saddle spinal is a reliable method for control of pain during labor. This method has rapid onset and causes complete sensory block without significant influence on motor neurons.

Our goal was to compare the analgesic efficacy and side effects of pethidine and sufentanil via saddle spinal administration during labor.

Methods:

600 parturients requesting analgesia were randomly divided into 2 groups. First group was composed of 300 patients received 0.4 mg/kg pethidine and the second group was composed of 300 patients received 0.1 μg/kg sufentanil. Then, analgesia according to Visual Analogue Scale (VAS), itching, nausea, apnea and urinary retention were examined between 2 groups.

Results:

VAS=3 was noted in both groups. Equal rate of apnea was seen in both groups. Patients received pethidine showed significantly a higher rate of nausea compared with sufentanil group (P<0.0001). Pruritus was significantly higher in patients received sufantanil (P<0.0001).

Conclusions:

Our findings suggest that saddle spinal by pethidine or sufentanil causes a considerable analgesia for labor. Proper management of the untoward effects of this method may introduce it as a safe and low-cost method for painless labor.

Key words

analgesia - painless labor - pethidine - sufentanil - pruritus - nausea

• References

• 1 Wong CA. Advances in labor analgesia. Int J Women Health 2009; 1: 139-154
• 2 Wall P, Melzack R. Wall and Melzack’s Text Book of Pain. 5^th ed. Philadelphia: W.B. Saunders Company; 2006: 802-813
• 3 Miller DR. Miller’s Anesthesia. 7^thed. Elsevier; 2008: 1654-1660
• 4 Goodman S, Smiley R, Negron M et al. Association of anesthetists of Great Britain and Ireland. Anaesthesia J 2011; 66: 191-212
• 5 Deballi P, Breen TW. Intrathecal opioids for combined spinal-epidural analgesia during labor. CNS Drugs 2003; 17: 889-904
• 6 Cohen S, Amar D, Pantuck CK. Epidural analgesia for labor and delivery: Fentanyl or sufentanil?. Can J Anesth 1996; 46: 341-346
• 7 Pandya ST. Labor analgesia: Recent advances. Indian J Anes 2010; s4: 400-408
• 8 Volikas I, Male D. A comparison of pethidine and remifentanil patient-controlled analgesia in labour. Int J Obstet Anesth 2001; 10: 86-90
• 9 Akkamahadevi P, Srinivas HT, Siddesh A et al. Comparison of efficacy of sufentanil and fentanyl with low-concentration bupivacaine for combined spinal epidural labor analgesia. Indian J Anes 2012; 365-3697
• 10 Evron S, Glezerman M, Sadan O et al. Remifentanil: A novel systemic analgesic for labor pain. Anesth Analg 2005; 100: 233-238
• 11 White JL, Durieux ME. Clinical pharmacology of local anesthetics. Anesthesiol Clin North Am 2005; 23: 73
• 12 Smith MT. Differences between and combinations of opioids re-visited. Curr Opin Anaesthesiol 2008; 21: 596
• 13 Bernards CM. Recent insights into the pharmacokinetics of spinal opioids and the relevance to opioid selection. Curr Opin Anaesthesiol 2004; 17: 441-447
• 14 Sudharma RJ, Birnbach D. Progress in analgesia for labor: focus on neuraxial blocks. Int J Women Health 2009; 1: 31-34
• 15 Blair JM, Dobson GT, Hill DA et al. Patient controlled analgesia for labor: a comparison of remifentanil with pethidine. Anaesthesia 2005; 60: 22-27