Efficacy of sufentanil addition to ropivacaine epidural anaesthesia for Caesarean section

B Bachmann-Mennenga, G Veit, B Steinicke, J Biscoping, M Heesen
Acta Anaesthesiologica Scandinavica 2005, 49 (4): 532-7

BACKGROUND: This prospective double-blind trial evaluated the effect of sufentanil addition to epidural ropivacaine for elective Caesarean section.

METHODS: Sixty healthy parturients were randomly assigned to receive an initial dose of 90 mg of plain ropivacaine, or 90 mg of ropivacaine plus 10 or 20 microg of sufentanil (n = 20 each). Before surgery, if necessary, additional epidural ropivacaine was injected. Primary outcome parameter was time to achieve sensory block at T4.

RESULTS: Time to reach the sensory block was remarkably reduced (P < 0.001 each) by addition of 10 or 20 microg of sufentanil (21 +/- 8 min, 15 +/- 5 min, 11 +/- 4 min in the plain ropivacaine, the 10- and 20-microg sufentanil groups, respectively) whereas the visual analogue scale (VAS) scores at delivery were significantly reduced (P = 0.028) only by 20 microg of sufentanil (32 +/- 35 mm in the plain ropivacaine vs. 9 +/- 19 mm in the 20-microg sufentanil groups). The total dose of ropivacaine was significantly lower (P = 0.005) in patients receiving 20 microg of sufentanil (100.5 +/- 15.0 mg) compared with those treated with plain ropivacaine (118.5 +/- 17.3 mg). The incidence of maternal side-effects (hypotension, bradycardia, nausea, vomiting, shivering, pruritus) and neonatal outcome [APGAR score, neurologic and adaptive capacity (NAC) score, umbilical cord blood-gas values] did not differ between the groups.

CONCLUSION: Our results suggest that addition of 20 microg of sufentanil improved the epidural anaesthesia with ropivacaine 0.75% for Caesarean section.

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