Extradural analgesia during labour using alfentanil

Abstract

Sixteen primiparous patients requesting pain relief during labour received a continuous infusion of alfentanil 30 μg kg-1 h-1 via an extradural catheter. Supplementary (extradural) bolus doses {30 μg kg-1) were administered when deemed necessary. Excellent pain relief was rapidly obtained early in labour in all patients. However, analgesia was inadequate in the latter part of stage I and during the second stage in five of the 16 patients-notwithstanding several additional doses of alfentanil, and bupi-vacaine had to be administered. No serious maternal side-effects, except nausea, were en-countered. Although all neonatal Apgar scores were between 7 and 10, the Amiel-Tison test clearly indicated the existence of neonatal hypotonia. The continuous extradural administration of alfentanil proved to be unsatisfactory for pain relief in labour. © 1987 British Journal of Anaesthesia.