INTRATHECAL BUPIVACAINE REDUCES PRURITUS AND PROLONGS DURATION OF FENTANYL ANALGESIA DURING LABOR - A PROSPECTIVE, RANDOMIZED CONTROLLED TRIAL

Citation
B. Asokumar et al., INTRATHECAL BUPIVACAINE REDUCES PRURITUS AND PROLONGS DURATION OF FENTANYL ANALGESIA DURING LABOR - A PROSPECTIVE, RANDOMIZED CONTROLLED TRIAL, Anesthesia and analgesia, 87(6), 1998, pp. 1309-1315
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Anesthesiology
Journal title
ISSN journal
0003-2999
Volume
87
Issue
6
Year of publication
1998
Pages
1309 - 1315
Database
ISI
SICI code
0003-2999(1998)87:6<1309:IBRPAP>2.0.ZU;2-I
Abstract
Pruritus is a frequent complication (40%-100%) of intrathecal (IT) fen tanyl 25 mu g (F) for labor analgesia. The addition of IT bupivacaine 2.5 mg (B) to F has been reported in a nonrandomized series to have a 17.3% incidence of pruritus. This study prospectively evaluated the in cidence and distribution of pruritus in laboring parturients receiving TT F + B. Sixty-five laboring parturients were randomly assigned to r eceive IT F, B, or F + B as part of a combined spinal-epidural techniq ue. Visual analog scores, sensory level, motor strength, and pruritus were recorded before injection and at intervals thereafter. When prese nt, the distribution of pruritus was evaluated. The duration of analge sia was determined as the time from TT drug administration until the p atient requested supplemental analgesia. The median duration of analge sia in the F, B, and F + B groups was 62.5, 55.0, and 94.5 min, respec tively. Compared with F alone, the combination of F + B led to a decre ased frequency of pruritus (36.4% vs 95%). The incidence of facial pru ritus (25%) was same in the F + B and F groups; however, the occurrenc e of pruritus distributed over the rest of the body was significantly more frequent in the F compared with the F + B group. The combination of F + B prolongs the duration of labor analgesia compared with IT F o r B alone. F + B also leads to a decreased incidence of pruritus, exce pt in the facial region. Implications: When administered intrathecally with fentanyl 25 mu g in laboring parturients, bupivacaine 25 mg atte nuates the frequency of pruritus on all parts of the body except the f ace. This combination also results in a rapid onset and prolonged dura tion of labor analgesia compared with either drug alone.