Bupivacaine with meperidine versus bupivacaine with fentanyl for continuous epidural labor analgesia.
OBJECTIVE
To compare the efficacy of bupivacaine-meperidine and bupivacaine-fentanyl mixtures when continuously infused epidurally to relief the labor pain.


METHODS
We performed this prospective double-blinded study at Jordan University Hospital, Amman, Jordan between October 2005 and April 2006. Sixty-seven American Society of Anesthesia physical status I parturients were randomly divided into 2 groups, Group M (n=34) received a continuous infusion of 1 mg/ml of bupivacaine mixed with 1 mg/ml meperidine, and Group F (n=33) received a continuous infusion of 1 mg/ml bupivacaine mixed with 2 micrometer/ml fentanyl. Efficacy of analgesia, degree of motor block, hemodynamic variability, incidence of nausea and vomiting, pruritus, sedation, and the neonatal outcome were all compared between the 2 groups. A p value <0.05 was considered to be significant.


RESULTS
Highly effective analgesia was achieved in both groups with a similar incidence of motor block, sedation, pruritus, and neonatal outcome. The only significant difference was in the incidence of nausea and vomiting. Group M had 8 parturients with nausea, compared with only 2 parturients in Group F (p=0.003).


CONCLUSIONS
Bupivacaine-meperidine in a continuous epidural infusion is as efficient as bupivacaine-fentanyl for pain relief during labor, but associated with a higher incidence of nausea and vomiting.
Massad
Islam M
IM
Department of General Surgery, Anesthesia and Intensive Care, University of Jordan, Jordan University Hospital, PO Box 13046, Amman, Jordan. islam_wafa@yahoo.com
Khadra
Maysa M
MM
Alkazaleh
Fawaz A
FA
Qatawneh
Ayman M
AM
Saleh
Shawqi S
SS
Abu-Halaweh
Sami A
SA
D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D008614:Meperidine / Q000008:administration & dosage*; D011247:Pregnancy
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D008614:Meperidine; D005283:Fentanyl; D002045:Bupivacaine