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Korean Journal of Anesthesiology 1999;37(2):262-267.
DOI: https://doi.org/10.4097/kjae.1999.37.2.262   
Comparison of Analgesic Effect of Fentanyl and Butorphanol during Patient-Controlled Epidural Analgesia for Labor Pain Control.
Dong Hee Kim, Seok Kon Kim, Kyung Sim Koh
1Departments of Anesthesiology, College of Medicine, Dankook University, Cheonan, Korea.
2Departments of Obstetrics and Gynecology, College of Medicine, Dankook University, Cheonan, Korea.
This study examined the efficacy of patient-controlled epidural analgesia (PCEA) during labor and compared the suitability of fentanyl and butorphanol mixed with bupivacaine.
After establishing effective epidural analgesia with 10 ml of 0.125% bupivacaine mixed with fentanyl 5 microgram/ml or butorphanol 1 mg/ml, 60 parturients in active labor were randomly assigned to one of two groups: PCEA using 0.0625% bupivacaine with fentanyl 2 microgram/ml (fentanyl group); PCEA using 0.0625% bupivacaine with butorphanol 20 microgram/ml (butorphanol group). PCEA pumps were programmed to deliver a 4 ml/hr basal infusion, 4 ml on-demand bolus, 10-min lockout intervals between doses, and a 20 ml hourly limit. Visual analogue pain scores, side effects, parturients' satisfaction scores, duration of labor and Apgar scores were recorded during and after labor.
The quality of analgesia, side effects, duration of labor, overall satisfaction and Apgar scores didn't differ between the two groups. Average hourly infusion rates were 11.8 0.3 ml/hr (fentanyl group) and 13.9 0.4 ml/hr (butorphanol group).
PCEA is a safe and effective method for labor analgesia and both solutions, the 0.0625% bupivacaine plus fentanyl 2 microgram/ml and the 0.0625% bupivacaine plus butorphanol 20 microgram/ml, appear suitable for PCEA use for labor pain. There is no difference in effectiveness between fentanyl and butorphanol.
Key Words: Analgesia, patient-controlled (PCA); Analgesics, fentanyl, butorphanol; Anesthesia, techniques, epidural


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