Comparison of Intrathecal Injection of Fentanyl and Sufentanil on the Onset, Duration, and Quality of Analgesia in Labor: A Randomized, Double-Blind Clinical Trial

Abstract

Background: Labor pain is a severe pain, and intrathecal opioid injection is one of the analgesia methods to reduce it. Objectives: We assessed the effects of intrathecal Fentanyl and Sufentanil on the onset, duration, and quality of analgesia for labor analgesia. Methods: In this double-blind, randomized clinical trial, 54 healthy nulliparous women 18 - 45 years in the active phase of labor who were requesting labor analgesia were enrolled in two groups fentanyl (F) and sufentanil (S). Patients received 75 µg fentanyl or 7.5 µg sufentanil intrathecally in the fentanyl group (n = 27) and the sufentanil group (n = 27), respectively. Pain relief, onset, duration of analgesia, hemodynamic parameters, patients' satisfaction, and neonatal Apgar score were assessed in this study. Data were analyzed by using SPSS16. Results: There were no significant differences between the groups in terms of demographic and hemodynamic parameters. The onset time of analgesia was 5.6 ± 4.3 and 3.6 ± 2.1 minutes, in the sufentanil and fentanyl groups, respectively (P = 0.037). The duration of analgesia was higher in patients who received sufentanil than those who received fentanyl (113 ± 45 vs. 103 ± 22 minutes (P = 0.629)). The pain score in the Fentanyl group was significantly lower at 5, 10, and 15 minutes after spinal analgesia (P < 0.05). The sedation score at 1 and 5 minutes was significantly higher in the fentanyl group than the sufentanil group (P < 0.05). The frequency and severity of pruritus and satisfaction rate in the fentanyl group were significantly higher than the sufentanil group. Conclusions: Intrathecal fentanyl and sufentanil have a similar analgesic effect on labor. Fentanyl is associated with a faster onset of analgesia and more satisfaction, while sufentanil has longer analgesia.

Eficacia y seguridad de la anestesia multimodal intratecal con fentanilo en cesárea: ensayo clínico

“…Estudios previos han reportado el manejo anestésico con fentanilo como coadyuvante a otros anestésicos intratecales en cesáreas y se ha demostrado que mejora la ca- lidad anestésica al disminuir las molestias en la manipulación visceral, mejora la analgesia postoperatoria y la duración del bloqueo; si bien resulta ser más eficaz con dosis mayores, incrementa el riesgo de aparición de eventos adversos (12)(13)(14) . El fentanilo como único agente anestésico intratecal resulta muy efectivo en el primer período del trabajo de parto debido a su actividad sobre las fibras nerviosas tipo C que se encuentran a nivel visceral (15,16) . Diferentes estudios del fentanilo con altas y bajas dosis de bupivacaína hiperbárica, con morfina y dexmedetomidina no han logrado demostrar la reducción de aparición de hipotensión, molestias transoperatorias ni efectos secundarios (17)(18)(19)(20)(21)(22)(23)(24) .…”

The Influence of Analgesic Modalities on Postoperative Cancer Recurrence

“…This decline in critical tumor-fighting cells has been shown in both animal and human models (54). Others have also demonstrated that fentanyl suppresses NK-cell levels (57). However, they also found that, at low doses, fentanyl does not suppress immune resistance to cancer (58).…”

Full Opioid Agonists and Tramadol: Pharmacological and Clinical Considerations

“…Fentanyl is a strong synthetic phenylpiperdine derivative that exhibits activity as a mu-selective opioid agonist, approximately 50 to 100 times more potent than morphine (26,27). It is one of the most commonly used opioid analgesics in modern anesthesia and pain therapy (28,29). Fentanyl had a relatively slow take-off after FDA approval and only precipitously increased in popularity after the concept of high-dose opioid anesthesia for critically ill patients undergoing open-heart surgery, and vascular surgery was introduced (26).…”