title: Extradural analgesia during labour using alfentanil.
abstract: Sixteen primiparous patients requesting pain relief during labour received a continuous infusion of alfentanil 30 micrograms kg-1 h-1 via an extradural catheter. Supplementary (extradural) bolus doses (30 micrograms kg-1) were administered when deemed necessary. Excellent pain relief was rapidly obtained early in labour in all patients. However, analgesia was inadequate in the latter part of stage I and during the second stage in five of the 16 patients--notwithstanding several additional doses of alfentanil, and bupivacaine had to be administered. No serious maternal side-effects, except nausea, were encountered. Although all neonatal Apgar scores were between 7 and 10, the Amiel-Tison test clearly indicated the existence of neonatal hypotonia. The continuous extradural administration of alfentanil proved to be unsatisfactory for pain relief in labour.
mesh_terms: D000328:Adult; D015760:Alfentanil; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000777:Anesthetics / Q000008:administration & dosage; D001034:Apgar Score; D004341:Drug Evaluation; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D010147:Pain Measurement; D011247:Pregnancy
chemical_list: D000777:Anesthetics; D015760:Alfentanil; D005283:Fentanyl