RESUMO
Continuous epidural administration of bupivacaine combined with fentanyl and sufentanil for obstetric analgesia provides adequate pain relief with a relatively rapid onset of analgesia and preservation of the motor functions as well as other sensations. The aim of this study is to establish the best technique of the extra dural block during labour using sufentanil and fentanyl combined with low dose of bupivacaine and assess the quality of analgesia and incidence of side effects. Sixty parturients from those attended labour wards in the active phase of the first stage of labour were classified into 3 groups each of them 20 parturients. Group I given bupivacaine, group II given bupivacaine and fentanyl and group III given bupivacaine and sufentanil. There was no statistically significant difference between the three groups just before injection of study solution, but such difference was statisticantly significant after 10 minutes between group I and II and group III with P value<0.01. At 30 minutes after injection path score was lower for the three groups than that at zero time but the pain score was still lower for group II, and III if compared with group I with P value<0.01. There was no statistically significant difference in the maternal heart rate [MHR] between the three groups before and after injection and in group I there was drop of maternal arterial blood pressure [MABP] with no effect in group II and III at the time of injection but there was statistically significant drop in MABP after 1 hour of injection in group I, otherwise, there was no significant difference in MAP between the three groups through the time of the study. There was no statistically significant difference between the three groups as regard of Apgar score either after 1 or 5 minutes as regard of umbilical vein blood gases. There was no significant difference between the three groups as regards PO[2], PCO2, pH. From this study we concluded that, the use of combined bupivacaine fentanyl or sufentanil epidurally for control of labour pain as these regimens guarantee the rapid-onset and better quality of analgesia with no effect on mode of delivery or neonatal outcome