Labor
analgesia with intrathecal
sufentanil has been shown to be prolonged by the addition of intrathecal
clonidine. The current study was designed to determine if epidural
clonidine would prolong labor
analgesia provided by epidural
sufentanil. Forty laboring primiparous women at less than 5 cm cervical dilation requesting
epidural analgesia were enrolled. Following a 3 mL test dose of
lidocaine with
epinephrine, patients were randomized to receive 10 mL of either
sufentanil 20 microg (S) or
sufentanil 20 microg with
clonidine 75 microg (SC). After administration of the
analgesic,
pain scores and side-effects were recorded for each patient at 5, 10, 15, 20 and 30 min, and every 30 min thereafter, by an observer blinded to the technique used. There were no demographic differences between the two groups.
Pain relief was rapid for all patients. The mean duration of
analgesia was similar between the S group (153 +/- 78 min) and the SC group (178 +/- 55 min). Side-effects were similar between the two groups. There was no difference between the two groups in time from
sufentanil administration to delivery, incidence of operative or assisted delivery, or cervical dilation at the time of redose. For early laboring patients, epidural
sufentanil 20 microg after a
lidocaine test dose provides
analgesia comparable to that of
sufentanil 20 microg with
clonidine 75 microg; there was no significant difference in
analgesic duration between the two groups.