Comparison of Fentanyl, Meperidine and Sufentanil for Intrathecal Labor Analgesia

Honet, James E.; Arkoosh, Valerie A.; Huffnagle, H. Jane; Norris, Mark C.; Leighton, Barbara L.

doi:10.1097/00000542-199109001-00838

Cited by 2 publications

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“…Miligan und Fogarty demonstrierten, dab die gleichzeitige Gabe von Heroin wfihrend einer Spinalan~isthesie mit Bupivacain zu einer signifikant verbesserten Analgesie nach Htfftersatzoperationen ftihrte [75]. Es wurde ebenfalls konstatiert, dab intrathekal injiziertes Sufentanil eine schnelle und effektive Analgesie unter der Geburt bewirkte [61,76]. In einer neueren kontrollierten Studie, bei der 10 gg Sufentanil entweder intrathekal, epidural oder intraven6s zur Ausschaltung des Geburtsschmerzes gegeben wurden, konnte gezeigt werden, dab nut intrathekales Sufentanil eine schnelle und gut wirkenden Analgesie ftir 1-2 h bewirkte, w~ihrend dies bei beiden anderen Applikationsmodi nicht zufriedenstellend gewahrleistet war.…”

Section: Epiduraler Oder Intrathekaler Applikauonsmodusunclassified

Klinischer Einsatz der rückenmarknahen Opioidanalgesie, Teil 1

Rawal

1996

Schmerz

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Spinal opioids are effective analgesics for surgical and non-surgical pain. Central and systemic side effects are less frequent than with epidural local anaesthetics or parenteral opioids. This review focuses on the analgesic efficacy of spinal opioids and their combination with local anaesthetics for postoperative analgesia, including patient-controlled epidural analgesia. Intrathecal administration of opioids has some advantages over their administration by the epidural route. Several factors may influence selection of the opioid; however, in most situations morphine is the drug of choice. Thoracic epidural administration of opioids seems to have no clinically important advantages over the lumbar route in terms of quality of analgesia, adverse effects, doses required or pulmonary function. However, evidence suggesting that effective postoperative analgesia can significantly improve postoperative morbidity in patients at risk is accumulating. In such patients, combined use of epidural local anaesthetics and opioids may become the technique of choice for postoperative analgesia. However, there is no evidence that this would have any clinically relevant benefit in low-risk patients.

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Section: Epiduraler Oder Intrathekaler Applikauonsmodusunclassified

Klinischer Einsatz der rückenmarknahen Opioidanalgesie, Teil 1

Rawal

1996

Schmerz

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Sufentanil: Clinical use as postoperative analgesic—Epidural/intrathecal route

Grass¹

1992

Journal of Pain and Symptom Management

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Although morphine and fentanyl remain the predominant epidural opioids, sufentanil offers some unique advantages. Because of its greater lipophilicity and mu-receptor binding capacity, sufentanil has a faster onset of action and longer duration than epidural fentanyl. Compared with morphine, sufentanil has been associated with a lower incidence of side effects, particularly delayed respiratory depression. The effective doses and adverse effects profile of epidural sufentanil are relatively well understood. Ventilatory depression is minimal with both bolus and continuous administration. Rapid vascular uptake after large epidural bolus, however, has been associated with acute-onset respiratory depression and even respiratory arrest. Sufentanil is more ideally suited than morphine to continuous epidural administration. The faster onset in comparison with fentanyl may make sufentanil the ideal agent for patient-controlled epidural analgesia. The synergistic effect of combined sufentanil and low-concentration bupivacaine offers advantages over sufentanil alone. High doses of epidural sufentanil have been uniquely associated with cessation of shivering and hypothermia. As with fentanyl, the intrathecal administration of sufentanil for postoperative analgesia is limited by its short duration of action.

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Comparison of Fentanyl, Meperidine and Sufentanil for Intrathecal Labor Analgesia

Cited by 2 publications

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Klinischer Einsatz der rückenmarknahen Opioidanalgesie, Teil 1

Klinischer Einsatz der rückenmarknahen Opioidanalgesie, Teil 1

Sufentanil: Clinical use as postoperative analgesic—Epidural/intrathecal route

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