title: Minimum analgesic doses of fentanyl and sufentanil for epidural analgesia in the first stage of labor.
abstract: In this study, we sought to determine the minimum analgesic doses and relative potencies of fentanyl and sufentanil when they are used as the sole epidural analgesic during the first stage of labor. Nulliparous parturients (n = 66) in spontaneous labor at term gestation and requesting epidural analgesia were enrolled into this prospective, double-blinded, randomized, sequential-allocation study. Each woman received fentanyl or sufentanil diluted with 0.9% wt/vol saline to a volume of 10 mL. The initial dose was arbitrarily chosen to be 125 microg for fentanyl and 25 microg for sufentanil, with subsequent doses being determined by the response of the previous patient (testing interval, 5 microg for fentanyl and 1 microg for sufentanil). Efficacy was accepted if the visual analog score decreased to < or =10 mm on a 100-mm scale within 30 min. The minimum analgesic dose or median effective dose was 21.1 microg (95% confidence interval [CI], 20.2-21.9 microg) for sufentanil and 124.2 microg (95% CI, 118.1-130.6 microg) for fentanyl (P < 0.0001). The sufentanil/fentanyl potency ratio was 5.9 (95% CI, 5.6-6.3). In conclusion, we have established the equivalent doses and relative potencies of fentanyl and sufentanil for epidural analgesia in the first stage of labor.
  
  
  CONCLUSIONS
  This study determined the minimum analgesic doses of fentanyl and sufentanil for epidural anesthesia in the first stage of labor. The sufentanil/fentanyl potency ratio was 5.9. This ratio may be used to establish the equivalent doses for fentanyl and sufentanil for epidural analgesia in labor.
authors.affiliation: *Department of Anesthesia, Città di Roma Hospital, Rome, Italy; and †Department of Anaesthesia and Intensive Care, South Manchester University Hospital, Wythenshawe, Manchester, United Kingdom.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Capogna
authors.forename: Michela
authors.initials: M
authors.lastname: Camorcia
authors.forename: Malachy O
authors.initials: MO
authors.lastname: Columb
mesh_terms: D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects; D016362:Analgesia, Obstetrical / Q000009:adverse effects; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D010092:Oximetry; D010147:Pain Measurement; D011247:Pregnancy; D011446:Prospective Studies; D017409:Sufentanil / Q000008:administration & dosage / Q000009:adverse effects; D014590:Uterine Contraction / Q000187:drug effects
chemical_list: D018686:Anesthetics, Intravenous; D017409:Sufentanil; D005283:Fentanyl