Bupivacaine in combination with fentanyl or sufentanil in epidural/intrathecal analgesia for labor: a meta-analysis.

Abstract

This study is to compare the effectiveness of combinational use of bupivacaine with fentanyl (BUPI-FEN) and sufentanil (BUPI-SUF) in epidural/intrathecal analgesia for labor. Electronic databases were searched for relevant research papers published between 1985 and 2014. Meta-analyses of mean differences or odds ratios were performed and statistical heterogeneity between the studies tested by I(2) index. Ten studies recruiting a total of 728 women in labor were selected. Concentrations of the anesthetics used as mean ± sd were bupivacaine 0.115 ± 0.056%, fentanyl 0.0007 ± 0.001%, and sufentanil 0.00017 ± 0.00022%. Duration of analgesia was not significantly different between BUPI-SUF and BUPI-FEN administered mothers (mean difference [95%CI] of -33.55 [-74.94, 7.83] minutes; P = .11) under random effects. The onset of analgesia was also not significantly different between both groups (mean difference [95%CI] of -0.61 [-1.38, 0.16] minutes; P = .12). The number of neonates with Apgar score < 7 was significantly lower in BUPI-FEN group (odd ratio [95%CI] of 0.31 [0.10, 0.95]; P < .05). Pruritus incidence was similar. In conclusion, BUPI-FEN combination exhibits significantly better tolerability at an approximate ratio of 6 FEN:1 SUF, albeit, both fentanyl and sufentanil in combination with bupivacaine provide similar analgesic properties via the epidural or intrathecal routes for labor pain relief.

• Authors: Bo Li, Huixia Wang, Chengjie Gao
• Journal: Journal of clinical pharmacology (J Clin Pharmacol) Vol. 55 Issue 5 Pg. 584-91 (May 2015) ISSN: 1552-4604 [Electronic] England
• PMID: 25535687 (Publication Type: Journal Article, Meta-Analysis)
• Copyright: © 2015, The American College of Clinical Pharmacology.

Chemical References

• Adjuvants, Anesthesia
• Anesthetics, Local
• Drug Combinations
• Sufentanil
• Fentanyl
• Bupivacaine

Topics

• Adjuvants, Anesthesia (administration & dosage, therapeutic use)
• Adult
• Anesthesia, Epidural (methods)
• Anesthesia, Obstetrical (methods)
• Anesthetics, Local (administration & dosage, therapeutic use)
• Apgar Score
• Bupivacaine (administration & dosage, therapeutic use)
• Drug Combinations
• Female
• Fentanyl (administration & dosage, therapeutic use)
• Humans
• Infant, Newborn
• Labor, Obstetric
• Pregnancy
• Sufentanil (administration & dosage, therapeutic use)