• R D'Angelo, J C Gerancher, J C Eisenach, and B L Raphael.
• Department of Anesthesiology, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, USA. rdangelo@bgsm.edu
• Anesthesiology. 1998 Jun 1;88(6):1519-23.

BackgroundThe purpose of this study was to determine if epidural fentanyl produces analgesia in laboring patients by a primary spinal or supraspinal action.MethodsFifty-four parturients were randomized to receive epidural 0.125% bupivacaine plus one of three treatments: epidural saline-intravenous saline, epidural fentanyl (20 microg/h)-intravenous saline, or epidural saline-intravenous fentanyl (20 microg/h). The study treatments were administered by continuous infusion, whereas epidural bupivacaine use was patient controlled.ResultsEpidural bupivacaine use was significantly reduced by epidural (11.5+/-4.6 ml/h) but not by intravenous fentanyl (15.9+/-4.5 ml/h) compared with saline control (16+/-5.9 ml/ h). Analgesia characteristics and side effects were similar among groups.ConclusionsLow-dose epidural infusions of fentanyl produce labor analgesia by a primary spinal action.

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