• H Le Guen, D Roy, B Branger, and C Ecoffey.
• Department of Anesthesiology and Surgical Intensive Care 2, Université de Rennes I, Rennes, France.
• J Clin Anesth. 2001 Mar 1;13(2):98-102.

Study ObjectivesTo compare the efficacy of fentanyl plus bupivacaine with sufentanil plus bupivacaine for treatment of pain during labor and delivery using patient-controlled epidural analgesia (PCEA).DesignProspective, double-blind, clinical investigation.SettingsUniversity-affiliated hospital.Patients226 ASA physical status I and II laboring patients.InterventionsPatients were randomized to receive 0.125% bupivacaine with fentanyl (2 micro g.ml(-1)) or 0.125% bupivacaine with sufentanil (0.25 micro g.ml(-1)) through PCEA.MeasurementsMaternal analgesia assessed by visual analog scale was recorded before epidural block, 1 and 3 hours after epidural block, at full cervical dilation, and at delivery. Motor blockade assessed by Bromage scale was recorded at delivery.Main ResultsNine patients in group fentanyl, and 11 in group sufentanil were excluded from the study. Overall analgesia was good and no difference was observed between the two groups. Total boluses of 4 mL bupivacaine-opioid administered and the number of supplementary top-up injections of 5 mL 0.25% bupivacaine were similar in both groups. In group sufentanil, motor blockade and pruritus were significantly lower than in group fentanyl. Nausea was not recorded in any patients. Mode of delivery was similar in both groups, i.e., cesarean section, vacuum or forceps, or spontaneous vaginal delivery. No difference was observed in Apgar scores.ConclusionsSufentanil is preferable to fentanyl during bupivacaine PCEA as there is less incidence of motor blockade and pruritus.

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