title: A high rate of epidural analgesia with bupivacaine-sufentanil is consistent with a low rate of caesarean section and instrumental deliveries.
abstract: OBJECTIVE
  To prospectively evaluate if a high rate of epidural analgesia (EDA) with bupivacaine-sufentanil is consistent with a low rate of caesarean section, instrumental deliveries and dystocia and to evaluate maternal and fetal adverse effects of sufentanil.
  
  
  METHODS
  Populations-based prospective descriptive study. A change of EDA from bupivacaine to low dose bupivacaine-sufentanil at the delivery unit of the hospital during 1993 resulted in a marked increase in the rate of EDA. The outcome from the study period (1994-1995) was compared to the outcome during a reference period 1991-1992.
  
  
  RESULTS
  There were no significant differences in the incidence of caesarean section and instrumental delivery for dystocia between the two periods (4.4 and 4.6%). The overall incidence of caesarean section, 9.6% and instrumental deliveries, 6.4% during the study period was lower than or comparable to the national background data (11.1 and 6.8%, respectively) while the EDA rate was markedly higher 37.8 versus 21.9%.
  
  
  CONCLUSIONS
  A high rate of EDA, using low dose bupivacaine and sufentanil is consistent with a low rate of caesarean section and instrumental deliveries. No apparent negative effects on the neonates or mothers were observed.
authors.affiliation: Department of Obstetrics and Gynecology, Orebro Medical Center Hospital, Orebro, Sweden. solveig.lindeberg@telia.com
authors.forename: S N
authors.initials: SN
authors.lastname: Lindeberg
authors.forename: T
authors.initials: T
authors.lastname: Thorén
authors.forename: U
authors.initials: U
authors.lastname: Hanson
mesh_terms: D015360:Analgesia, Epidural / Q000706:statistics & numerical data*; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D002045:Bupivacaine / Q000009:adverse effects / Q000627:therapeutic use*; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D004420:Dystocia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D017409:Sufentanil / Q000009:adverse effects / Q000627:therapeutic use*; D013548:Sweden / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D017409:Sufentanil; D002045:Bupivacaine