بررسي تاثير تزريق يك دوز منفرد سوفنتانيل و بوپيواكايين به فضاي زير عنكبوتيه بر بيدردي و ميزان سزارين

Subarachnoid Sufentanil-Bupivacaine Efficacy on Labor Analgesia and Cesarean Section Rate

Introduction: The efficacy of subarachnoid sufentanil-bupivacaine for pain relief has been found. These drugs may affect not only labor pain but also duration of labor, delivery way (vaginal, instrumental or cesarean) and mother and fetus systems. The object of this study is definition of subarachnoid sufentanil-bupivacaine efficacy on labor analgesia and cesarean rate. Material and Methods: 41 parturient who requesting labor analgesia (interaction group= I) compared with 41 parturient who did not requesting analgesia (comparison group=C). We did not do any procedure on C group. Patients in group I received intrathecal sufentanil 7.5 µg and bupivacaine 2.5 mg via 27G spinal needle guided by I8G needle. Visual analogue scores (VAS) for pain, vital signs (BP, HR, and RR), neonatal apgar and duration of labor measured and recorded for two groups. Incidence of nausea, vomiting, pruritus, hypotension, motor block and post dural puncture headache also were recorded for patients in group I. Results: There were no significant differences between two groups in relation to age and parity. VAS in cervical dilatation of 4 cm at the zero point and 40, 80, 120, and 160 minutes after that was 3.3, 3.7, 4.2, 4.7, and 5.5 for C group and 4.4 , 0.1, 0.1, 1.5 and 3.1 for I group respectively (P<0.05). VAS was 2.2 for I group versus 6.5 in C group in stage 11 of labor (P<0.05). The duration of labor from zero point was 173 min in C group versus 127 min in I group (P<0.05). Cesarean section was performed in 5 (12.2%) cases of C group and 2(4.9%) cases of I group. Vacuum extraction was done in 3 (7.3%) cases of C group and 4 (9.8%) cases of I group, apgar scores in two groups were high and there were no apgar under 7. The incidence of pruritus was 39.2%. One of patients (2.4%) experienced nausea and postural puncture headache developed in two of patients (4.9%). Non of the patients developed hypotension or motor block. Conclusion: Intrathecal sufentanil 7.5 µg combined with bupivacaine 2.5mg is a very effective analgesic in stage I of labor and decreases the pain of stage II of labor also this accelerated labor process and did not affect cesarean rate and instrumental delivery.