Combined Epidural Sufentanil and Bupivacaine for Labor Analgesia

Abstract

This study was done to determine if the addition of sufentanil 2 μg/ml to epidural 0.125% bupivacaine would provide analgesia in labor of comparable quality to that provided by 0.25% bupivacaine. Patients (n = 50) in labor at term were randomly divided into two equal groups. Group A received epidural 0.25% bupivacaine and Group B received epidural 0.125% bupivacaine containing 2 μg/ml of sufentanil. Time to onset and quality of analgesia were comparable in both groups. There was no detectable motor block in Group B, whereas 10 patients in Group A had a mild or moderate degree of motor block. Both the total dose of bupivacaine administered and the dose rate per hour of bupivacaine were significantly lower in Group B than in Group A ( p < 0.001). Nine patients in Group B complained of mild pruritus; no other significant side effects were seen. These results demonstrate that epidural 0.125% bupivacaine with sufentanil 2 μg/ml can be substituted for 0.25% bupivacaine for labor analgesia. Benefits to the patient include minimal motor block and decreased risk of drug toxicity, as the dose of bupivacaine is reduced.