J Korean Pain Soc.
2004 Dec;17(2):207-211. 10.3344/jkps.2004.17.2.207.
Comparison of Intrathecal Injection with Epidural Injection of Opioids and Local Anesthetics for Labor Analgesia
- Affiliations
-
- 1Department of Anesthesiology, College of Medicine, Dankook University, Cheonan, Korea. ybs90@unitel.co.kr
- 2Department of Obstetrics and Gynecology, College of Medicine, Dankook University, Cheonan, Korea.
- KMID: 2104856
- DOI: http://doi.org/10.3344/jkps.2004.17.2.207
Abstract
- BACKGROUND
Intrathecal sufentanil has been found to provide profound analgesia during labor. The analgesic effect of intrathecal sufentanil, morphine and hyperbaric bupivacaine were compared with that of epidural fentanyl and bupivacaine for labor pain. METHODS: Thirty women received either 2 ml of 10microgram intrathecal sufentanil with 0.2 mg morphine and 3.5 mg bupivacaine (intrathecal group; n = 15) or 10 ml of 0.125% bupivacaine mixed with fentanyl 5microgram/ml (epidural group; n = 15) during active labor. When pain occurred, 50 mg meperidine was injected intravenously in the intrathecal group, or a patient-controlled epidural analgesia (PCEA) pump, using 0.0625% bupivacaine with fentanyl 2microgram/ml, was programmed to deliver a 4 ml/h basal infusion and a 4 ml on-demand bolus, with 10-min lockout intervals, was activated in the epidural group. RESULTS: The quality of analgesia, side effects, duration of labor, overall satisfaction and Apgar scores did not differ between the two groups. Motor weakness and urinary retention were significantly lower in the intrathecal group (P< 0.05). CONCLUSIONS: Intrathecal sufentanil, with morphine and bupivacaine or epidural fentanyl and ropivacaine, provides safe and effective analgesia during labor. However, intrathecal opioids, with low-dose local anesthetics, appear to have lower incidences of motor blockade than epidural local anesthetics, with opioid, in analgesia for labor pains.
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