Anesthesia & Clinical Research
Open Access

Abstract

Comparison of Different Bupivacaine and Fentanyl Combinations When Used with A Single Shut Spinal Block for Labor Analgesia

Bilge Aslan, Müge Arikan, Ahmet Gedikli and Özlem Moraloğlu

Background: Single-shot spinal analgesia with bupivacaine plus a short-acting opioid is an effective technique for pain control in labor, and it is particularly useful in the active phase. We compared the effects of adding two different doses of fentanyl (15 μg or 25 μg) to intrathecal bupivacaine, and to evaluate the impacts on duration of labor analgesia, newborn, and side effects.

Method: One hundred and five multiparous healty women in advanced labor (cervical dilatation ≥ 7 cm, and pain score >5), requesting labor analgesia were included in the study. They were randomly allocated into three groups. Group I received 2.5 mg bupivacaine; Group II received 2.5 mg bupivacaine plus 15 μg fentanyl; Group III received 2.5 bupivacaine plus 25 μg fentanyl intrathecally. The patients' demo figure characteristics, hemodynamic parameters, pain scores (by using visual analogue scale - VAS), analgesic requirements, duration of analgesia (the time from intrathecal injection to the return of pain >4), fetal Apgar scores (at 1st and 5th min), and maternal and neonatal side effects were recorded. We used analysis of variance (ANOVA), post hoc test with Bonferroni adjustment, and chi-square test for statistical analysis; the analyses were performed using the SPSS-16 software. Given a significant level of 0.05, overall and pair-wise comparisons were made.

Results: The mean VAS scores were significantly lower in Group II than in the other two groups at 5, 15, 30 min, and 1 h (P<0.001). There was no difference among Group I and Group III. The VAS scores were significantly higher in the Group III than in the other two groups at 2 (P=0.005) and 3 h (P<0.001). The incidence of adverse events was similar in all three groups. There was no difference in Apgar scores at 1 min, but Apgar score at 5 min was higher in Group 2 (P=0.02).

Conclusion: In this study, we found that 2.5 mg of bupivacaine plus 15 μg fentanyl is more preferable option for SSA.