Comparison of intra techal injection of fentanyl and sufentanil on the onset, duration and quality of analgesia in vaginal delivery under spinal anesthesia .

Comparison of intra techal injection of fentanyl and sufentanil on onset, duration and quality of analgesia in vaginal delivery under spinal anesthesia .

50 patients are entered into a double-blind, phase 2-3 clinical trial and randomly assigned into 4 blocks and entered into one of the two groups of spinal analgesia by Fentanyl and Sufentanil.

In patients candidate for labor analgesia in Fatemiyeh Hospital of Hamadan ,randomly 1.5 ml fentanyl or sufentanil is injected intratechally .So that, patient, evaluator and anesthesiologist do not know the type of injected drug.

Inclusion Criteria: Patients with class 1 and 2 of ASA ; Second pregnancy Gestational age 36 to 40 weeks; Aged 18 to 45 years ; Cervical dilatation is more than 5 cm Exclusion Criteria: Heart disease; Diabetes; Spinal anesthesia Contraindication ; History of opioid use in 24 hours before delivery.

Patients were placed in a sitting position and 25 Quinke needle inserted into L3-L4 or L4-L5 space and after aspiration of cerebrospinal fluid , 1.5 ml of Fentanyl or Sufentanil(in group A or B) is injected into the subarachnoid space by an anesthetist who has no known medication .

After the spinal block, maternal vital signs; VAS of pain; maternal sedation score and FHR are determined every 5 minutes to 15 minutes, and then every 15 minutes to 3 hours.Time to reduce pain; duration of analgesia ; patient's satisfaction; Apgar score in the first and fifth minutes; duration of the first and second stages of labor; the need for cesarean section; itching; nausea and vomiting are also recorded in the questionnaire.

In this study, the randomization method is used as a 4-block . In this way, according to the sample size, 12 blocks are identified, and in each of these four blocks, two of each group will be written in the form of letters A or B. This means that two A and two B are written in each block, although the order of the writing of the four letters A and B will be different in each block. The periodic numbers table will then be used to determine the order of block selection.

All patients, after entering the operating room using Angiocath 18, received 500 ml of Ringer serum and patient's primary vital signs are measured by a non-invasive monitoring device. Then the patient is placed in a sitting position and placed under spinal anesthesia with spinal Quincke needle number 25 in L4-L5 or L3-L4 space, and after leaving the cerebrospinal fluid from the needle tip and correcting the subarachnoid space,1.5 ml of one of the two drugs fentanyl or sufentanil that prepared by an anesthetist nurse ((Which does not know the study)) in syringes of the same size and shape , is drawn into sterile syringe by anesthetist and is injected into the sub-arachnoid space, in each patient two groups A or B. Thus, the patient, anesthetist (assessor), and an analyzer are not aware of any prescriptive substance.