Efficacy of fentanyl versus sufentanil for labour analgesia and its comparative evaluation with intramuscular tramadol

Abstract

Introduction: Knowledge about relative merits and demerits of different techniques of administration of drugs through epidural route is needed for optimum management of labour pain. Primary objective of this study is to assess the efficacy of fentanyl and sufentanil for labour analgesia in comparison with intramuscular tramadol. Materials and Methods: This prospective randomized control study included 90 primigravida parturients who were randomly allocated to three groups of 30 each; Fentanyl group (group BF) received 50 mg of epidural fentanyl with 10 ml of 0.125% bupivacaine, Sufentanil group (group BS) received 10mg epidural sufentanil with 10 ml of 0.125% bupivacaine and Tramadol group (group T), the control group received 100mg intramuscular tramadol with 50 mg repeat dose after 4 hours. Results: Epidural groups were comparable in their visual analogue scale (VAS) score satisfaction score, characteristics of sensory and motor blockade, mode of delivery, side effects, haemodynamic stability and neonatal outcome. Value of VAS did not exceed 3 in the epidural group during the entire study period. Onset of analgesia was early with sufentanil (10.52.1 mins, p used was also less (44.16 mg, p =0.002). Higher VAS scores (>4), delayed onset and decreased total duration of labour was seen in tramadol group. Epidural and tramadol group were comparable in mode of delivery and neonatal outcome. Conclusion: Quality of epidural analgesia with either fentanyl or sufentanil using intermittent bolus technique was comparable. Duration of first and second stage of labour was significantly prolonged in parturients receiving labour epidural analgesia. Keywords: Bupivacaine, Fentanyl, Sufentanil, Labour, Analgesia.