Single-shot intrathecal sufentanil with bupivacaine in late labour--analgesic quality and obstetric outcome.
OBJECTIVE
To investigate the analgesic effect and obstetric outcome after single-shot intrathecal sufentanil with bupivacaine in late labour.


METHODS
Forty multiparous women in advanced labour were given a spinal injection of sufentanil 7.5 microg and bupivacaine 2 mg. Pain intensity was recorded by the parturient on a visual analogue scale. The quality of pain relief was also rated with a verbal score directly after delivery. Side effects, such as hypotension, pruritus, sedation, nausea and motor block were noted. Obstetric parameters were followed and recorded. Apgar score and umbilical artery pH were noted.


RESULTS
Median visual analogue scores after 5, 15, 30, 60, 90, 120 and 150 min were 1.5, 0.5, 0, 1, 1.5, 2 and 3, respectively. Seventy-seven percent of the parturients scored the analgesic quality as excellent. Six parturients had hypotension. Motor block, sedation and nausea were rare. Pruritus was seen in 85% of the cases. No ceasarean section was performed. Vacuum extraction was done in six (15%) cases. Oxytocin augmentation was needed in 26 (65%) of the parturients. Fetal heart rate disturbances following the spinal block were seen in four cases. Apgar scores were high. No neonate had Apgar < 7.


CONCLUSIONS
Intrathecal block with sufentanil 7.5 microg in combination with bupivacaine 2 mg is a very effective pain relief in late labour. Due to its limited duration it is important to select women in rapid progress of labour, and active obstetric management is necessary. It is also very important that the obstetrician is aware of the risk of non-reassuring fetal heart rate changes after intrathecal block.
Eriksson
Susanne Ledin
SL
Department of Anaesthesiology and Intensive Care, Gävle-Sandviken County Hospital, SE-80187, Gavle, Sweden. susanne.ledin-eriksson@lg.se
Blomberg
Inger
I
Olofsson
Christina
C
D016362:Analgesia, Obstetrical / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D001034:Apgar Score; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007278:Injections, Spinal; D007743:Labor, Obstetric; D010121:Oxytocin / Q000008:administration & dosage; D010147:Pain Measurement; D011247:Pregnancy; D011256:Pregnancy Outcome; D017409:Sufentanil / Q000008:administration & dosage* / Q000009:adverse effects; D014469:Umbilical Arteries; D014620:Vacuum Extraction, Obstetrical
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D010121:Oxytocin; D017409:Sufentanil; D002045:Bupivacaine