Article OriginalAssociation sufentanil-bupivacaïne à 0,25 % par voie péridurale pour l'analgésie obstétricale. Comparaison avec le fentanyl et un placeboA controlled trial of extradural 0.25 % bupivacaine with either sufentanil, fentanyl or placebo for labour pain relief

The study reported was designed to determine whether 15 μg sufentanil would provide analgesia comparable in duration and quality with that given by 75 μg fentanyl, when associated with plain 0.25 % bupivacaine for extradural analgesia for labour. Patients (n = 124) in labour and at full term were randomly divided into 3 groups. Group 1 (n = 41) were given 12 ml of 0.25 % plain bupivacaine with saline, group 2 (n = 41) 12 ml of 0.25 % plain bupivacaine with 75 μg fentanyl and group 3 (n = 42) 12 ml of 0.25 % plain bupivacaine with 15 μg sufentanil. 11 cases were excluded from the study (8 Caesarean sections, 3 technical failures). The duration of analgesia obtained with the two opioids was similar (group 2 : 126.7 ± 6.5 min, p < 0.01 ; group 3 : 114.9 ± 5.8 min, p < 0.01 ; group 1 : 93.6 ± 5.4 min) as well as the quality of pain relief. There were no differences between the three groups with regard to Apgar scores. The only side-effect seen with sufentanil and fentanyl was pruritus (group 2 : 21.9 %, p < 0.05 ; group 3 : 21.4 %, p < 0.05 ; group 1 : 2.4 %). These results showed that 15 μg sufentanil could replace 75 μg fentanyl for extradural pain relief of labour with plain 0.25 % bupivacaine. However, the use of opioids with local anaesthetics would seem to be of interest only if labour is likely to be prolonged.