Optimizing epidural fentanyl loading dose for early labor pain

Feng Fang Tsai, Gong Jhe Wu, Chen Jung Lin, Chi Hsiang Huang, Shiou Sheng Chen, Li Kuei Chen

研究成果: 雜誌貢獻文章同行評審

2 引文 斯高帕斯(Scopus)


Objective: Sufficient sensory blockade between L1 and T10 is required to relieve visceral pain during early labor. We examined whether the addition of fentanyl to a loading dose of 0.0625% bupivacaine could provide dose-dependent analgesic effects on early-stage labor pain. Methods: Sixty parturients who requested epidural analgesia for labor pain were enrolled and randomly allocated to one of three groups. Group A (n=20) received 10 mL of 0.0625% epidural bupivacaine as a loading dose alone. Group B (n=20) received the same bupivacaine loading dose in combination with 2 μg/mL fentanyl. Group C (n=20) received the same loading bupivacaine dose plus 4 μg/mL fentanyl. All patients received diluted bupivacaine plus 2 μg/mL fentanyl at a rate of 10 mL/hr as a maintenance dose. Fifteen minutes later, we recorded the highest cephalic and lowest caudal anesthetized dermatomes, side effects, and the number of patients who asked for supplemental analgesia. Results: The highest anesthetized cephalic dermatome was at the level of T12 (T9-L1) in Group A, T9 (T8-T12) in Group B and T7 (T5-T9) in Group C (p<0.05 among the three groups). Eleven patients (55%) requested supplemental bupivacaine for inadequate analgesia in Group A, six in Group B (30%), and none in Group C (0%). Pruritus was reported by seven (35%) patients in Group B and eight (40%) patients in Group C, but none in Group A. Conclusion: The addition of fentanyl to epidural bupivacaine dose-dependently increased the analgesic effect and higher loading doses of fentanyl increased the dermatomic coverage. We suggest that 0.0625% bupivacaine plus 4 μg/mL fentanyl is the ideal loading dose to provide the greatest segmental analgesia for early labor pain with minimal side effects.

頁(從 - 到)167-172
期刊Acta Anaesthesiologica Taiwanica
出版狀態已發佈 - 12月 2009

ASJC Scopus subject areas

  • 麻醉與疼痛醫學


深入研究「Optimizing epidural fentanyl loading dose for early labor pain」主題。共同形成了獨特的指紋。