What opioids are used to provide spinal and epidural analgesia during labor Name their most common side effects Do they provide adequate analgesia for labor and delivery when used alone

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The most commonly used neuraxial (spinal and epidural) opioids are fentanyl and sufentanil (Table 60-2). Pruritus, nausea, and vomiting are the most common side effects; delayed respiratory depression is the most serious complication, although very uncommon in this

TABLE 60-2.

OPIOIDS USED TO PROVIDE INTRATHECAL (SPINAL) ANALGESIA

DURING LABOR

Drug

Dose

Fentanyl

25 mcg

Sufentanil

5 mcg

Morphine

0.25 mg

Meperidine

10 mg

population. Intrathecal or epidural opioids alone may provide adequate relief for the early stages of labor, but they are unreliable in producing adequate analgesia for the active phase of labor. Very high doses of epidural opioids are required, which leads to excessive side effects. Concurrent administration of local anesthetic is necessary for late cervical dilation and delivery of the infant.

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