Sufentanil vs fentanyl in combination with ropivacaine for patient-controlled epidural analgesia during labor

Objective To compare the efficacy of sufentanil and fentanyl in combination with ropivacaine for patient controlled epidural analgesia (PCEA) during labor.Methods One-hundred and twenty nulliparous parturients in active labor (cervical dilatation=3 cm) were randomized to receive a test dose of 5 ml of 0.15% ropivacaine with 0.5μg·ml~(-1) sufentanil (group S,n=60) or 2.0μg·ml~(-1) fentanyl (group F,n=60) and were observed for 5 ml.When correct placement of epidural catheter was confirmed another 10 ml was given.PCEA was commenced with 0.1% ropivacaine+0.5μg·ml~(-1) sufentanil/2.0μg·ml~(-1) fentanyl.The PCEA pump was set up with a bolus of 6 ml and lockout interval of 15 min without background infusion.The following were recorded:(1) pain intensity was assessed using VAS (0-10);(2) motor block was assessed using Bromage scale;(3) onset of analgesia after epidural injection;(4) fetal HR;(5) maternal vital signs;(6) Apgar score;(7) labor process; (8) mode of delivery and (9) the total amount of analgesics comsumed.Results VAS scores were significantly decreased starting from 5 min after epidural analgesia was started.The VAS scores were significantly lower at 20, 30 and 60 min after epidural medication in group S than in group F.There were no significant differences in onset of analgesia,block height,the number of attempts and the number of successful delivered doses between the two groups.The amount of sufentanil consumed was (16±86)μg and of fentanyl (70±28)μg,The ratio was 1:4,4. The duration of active phase or second stage and the mode of delivery were similar in both groups.Conclusion Equivalent doses of sufentanil and fentanyl plus ropivacaine provide good analgesia for labor.