Abstract | OBJECTIVE: Sufficient sensory blockade between L1 and T10 is required to relieve visceral pain during early labor. We examined whether the addition of fentanyl to a loading dose of 0.0625% bupivacaine could provide dose-dependent analgesic effects on early-stage labor pain. METHODS: Sixty parturients who requested epidural analgesia for labor pain were enrolled and randomly allocated to one of three groups. Group A (n = 20) received 10 mL of 0.0625% epidural bupivacaine as a loading dose alone. Group B (n = 20) received the same bupivacaine loading dose in combination with 2 microg/mL fentanyl. Group C (n = 20) received the same loading bupivacaine dose plus 4 microg/mL fentanyl. All patients received diluted bupivacaine plus 2 microg/mL fentanyl at a rate of 10 mL/hr as a maintenance dose. Fifteen minutes later, we recorded the highest cephalic and lowest caudal anesthetized dermatomes, side effects, and the number of patients who asked for supplemental analgesia. RESULTS: The highest anesthetized cephalic dermatome was at the level of T12 (T9-L1) in Group A, T9 (T8-T12) in Group B and T7 (T5-T9) in Group C (p < 0.05 among the three groups). Eleven patients (55%) requested supplemental bupivacaine for inadequate analgesia in Group A, six in Group B (30%), and none in Group C (0%). Pruritus was reported by seven (35%) patients in Group B and eight (40%) patients in Group C, but none in Group A. CONCLUSION:
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Authors | Feng-Fang Tsai, Gong-Jhe Wu, Chen-Jung Lin, Chi-Hsiang Huang, Shiou-Sheng Chen, Li-Kuei Chen |
Journal | Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
(Acta Anaesthesiol Taiwan)
Vol. 47
Issue 4
Pg. 167-72
(Dec 2009)
ISSN: 1875-452X [Electronic] China (Republic : 1949- ) |
PMID | 20015816
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Analgesics, Opioid
- Fentanyl
- Bupivacaine
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Topics |
- Adult
- Analgesia, Epidural
- Analgesia, Obstetrical
- Analgesics, Opioid
(administration & dosage)
- Bupivacaine
(administration & dosage)
- Dose-Response Relationship, Drug
- Female
- Fentanyl
(administration & dosage, pharmacology)
- Humans
- Labor Pain
(drug therapy)
- Pregnancy
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