Comparison of clinical effects according to the dosage of sufentanil added to 0.5% hyperbaric bupivacaine for spinal anesthesia in patients undergoing cesarean section

Abstract

BackgroundSubarachnoid block is a widely used technique for cesarean section. To improve the quality of analgesia and prolong the duration of analgesia, addition of intrathecal opioids to local anesthetics has been encouraged. We compared the effects of sufentanil 2.5 µg and 5 µg, which were added to intrathecal hyperbaric bupivacaine.MethodsWe enrolled 105 full term parturients were randomly divided into 3 groups: Group 1 (control), Group 2 (sufentanil 2.5 µg), and Group 3 (sufentanil 5 µg). In every group, 0.5% heavy bupivacaine was added according to the adjusted dose regimen. We determined the maximum level of sensory block and motor block, the quality of intraoperative analgesia, the duration of effective analgesia and side effects.ResultsThere were no significant differences among the 3 groups in the maximum level of the sensory block and motor block. Recovery rate of the sensory block, however, was significantly slower in Group 3 than Group 1. Quality of intraopertive analgesia, muscle relaxation, and duration of effective analgesia were enhanced by increasing the dosage of intrathecal sufentanil. Frequencies of hypotension, maximum sedation level, and pruritus were directly related to the dosage of intrathecal sufentanil, whereas nausea and vomiting occurred only in the groups using sufentanil.ConclusionsThe addition of sufentanil 2.5 µg for spinal anesthesia provides adequate intraoperative analgesia and good postoperative analgesia with minimal adverse effects on the mother.

Sufentanil and Bupivacaine Combination versus Bupivacaine Alone for Spinal Anesthesia during Cesarean Delivery: A Meta-Analysis of Randomized Trials

“…Five trials examined 1 dose of the drug sufentanil[ 9 – 13 ], and the rest 4 examined more than 1 dose (2 trials examined 2 doses[ 14 , 15 ], 2 trials examined 3 doses[ 16 , 17 ]). Trials that tested more than 1 dose were combined to create a single pair-wise comparison as previously mentioned.…”

“…Six trials [ 9 – 12 , 14 , 16 ] were pooled using a fixed effect model since no heterogeneity was observed (I 2 < 0.1%, P = 0.73) when their anesthesia quality were examined. Bupivacaine and sufentanil combination significantly reduced the incidence of breakthrough pain during surgery compared with bupivacaine alone(RR = 0.10, 95% CI 0.06 to 0.18 P < 0.001, Fig 2 ).…”

Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Randomized controlled study

“…In the last decades, the increased use of spinal sufentanil in combination with local anesthetics has been observed 1,2,[5][6][7][20][21][22][23] . In spinal blocks for labor analgesia and cesarean section, it has been described that the potency of sufentanil is increased around In our study, pain was reported by four patients who received fentanyl and three patients from the sufentanil group, occurring at a mean time of 96 and 81 minutes, respectively.…”

“…It may be desirable and favorable without interfering with mothernewborn interaction. In a study by Lee et al 22 , the majority of patients who received local anesthetic alone were reported to be awake and anxious, while light sedation with easy arousal was a…”

Spinal Additives in Subarachnoid Anaesthesia for Cesarean Section

“…There were no differences in the newborn evaluation. Bang et al [80] compared a placebo group versus 2.5 versus 5 µg sufentanil added to spinal hyperbaric bupivacaine and reported no significant differences among the 3 groups regarding the maximum sensory levels and motor block. Patients receiving 5 µg sufentanil had slower recovery of the sensory block.…”