Open AccessComparison of Effect of Meperidine Versus Fentanyl as an Adjuvant to Epidural Bupivacaine on Duration of Labor: A Randomized Controlled Study
Author(s) -
Masoomeh Nataj Majd,
Maryam Farid Mojtahedi,
Ahmad Reza Taheri,
Mehdi Sanatkar,
Nader Ali Nazemian Yazdi
Publication year - 2022
Publication title -
acta medica iranica.
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.218
H-Index - 27
eISSN - 1735-9694
pISSN - 0044-6025
DOI - 10.18502/acta.v60i3.9002
Subject(s) - medicine , fentanyl , bupivacaine , anesthesia , apgar score , bolus (digestion) , randomized controlled trial , labor pain , pregnancy , surgery , fetus , biology , genetics
Epidural analgesia (EA) is one of the best pain relief for many pregnant women in labor. This study was conducted to evaluate the effect of epidural analgesia provided by a combination of bupivacaine plus meperidine or fentanyl on the mother, fetus, and labor process in term nulliparous women. A total of 558 nulliparous women were randomized into two groups of 279 subjects. The BF (Bupivacaine-Fentanyl) group received 16 ml bupivacaine 0.125% plus 50 mg fentanyl as a loading dose; then, an intermittent bolus of the same solution was administered once the patient requested analgesia. The BM (Bupivacaine-Meperidine) group received a loading dose of 16 ml bupivacaine 0.125% plus 20 mg meperidine followed by an intermittent bolus of the same solution if the patient requested analgesia. The time of labor phases 1 and 2 and the incidence of side effects were recorded. After the intervention, the pain score was significantly lower in the meperidine group compared to the fentanyl group during labor (P=0.006). The duration of the active phase of labor (P=0.04) and the rate of cesarean section (P=0.01) were significantly higher in the fentanyl group compared to the meperidine group. The duration of the second stage of labor was not significantly different between the two groups (P=0.24). Apgar score was significantly higher in the meperidine group. This study found that epidural meperidine could be a suitable alternative to fentanyl for improving pain relief and shortening the active phase of delivery without increasing the risk of the neonatal low Apgar score.