Effectiveness of Patient-Controlled Intravenous Analgesia (PCIA) with Sufentanil Background Infusion for Post-Cesarean Analgesia: A Randomized Controlled Trial

Abstract

Purpose To investigate the effectiveness of sufentanil patient-controlled intravenous analgesia pump (PCIA) and background infusion in patients of post-cesarean analgesia. Patients and Methods This trial compared two groups of women undergoing cesarean section and receiving PCIA: no background infusion group (n=30), 6-min lockout time, and background infusion group (n=30), 2 mL/h infusion, 10-min lockout time. Both groups with 2 μg/kg sufentanil was diluted to 100 mL with normal saline. VAS scores at rest at 36 h was the primary endpoint. The secondary endpoints were the VAS scores at rest at 6, 12, and 24 h, the total amount of sufentanil consumed, the Ramsay sedation score (RSS) assessed at the same time points, postpartum bleeding within 24 h, the injection/attempt (I/A) ratio, BP and HR, PONV, side effects of sufentanil. Results Compared with the no background infusion group, the background infusion group showed lower VAS pain scores at 6, 12, and 24 h (P<0.01), but no differences at 36 h (95% CI = −0.5–0.8. P>0.05). Attempts, injections, and total sufentanil consumption were significantly different between the two groups (P<0.001), but without difference in I/A. Bleeding was less in the background infusion group at 1 h (P=0.03). The minimal respiration rates were not significantly different between groups. Conclusion Background infusion increased the total consumption of sufentanil within 36 h after cesarean section. Although it did not reduce uterine contraction pain and wound pain at 36 h, it significantly reduced the pain at 6, 12, and 24 h after cesarean section. It improved patient satisfaction and reduced the amount of bleeding after 1 h. Importantly, it did not increase the incidence of hypertension, PONV and respiratory depression.

Patient‐controlled intravenous administration of dexmedetomidine with nalbuphine versus sufentanil for post cesarean delivery analgesia: A retrospective observational study

“…If postoperative nausea/vomiting developed, azasetron (10 mg) intravenous injection was administered. If severe nausea persisted after two consecutive rescue antiemetics, PCIA was stopped for 2 h and restarted later when the symptoms subsided 13 . No treatment for pruritus and chills was performed due to the patients' tolerance.…”

“…If severe nausea persisted after two consecutive rescue antiemetics, PCIA was stopped for 2 h and restarted later when the symptoms subsided. 13 No treatment for pruritus and chills was performed due to the patients' tolerance. A urinary catheter was reinserted in case of any urinary retention.…”

“…Binding of NAL to μ‐receptor decreased the side effects of μ‐agonist, and to κ‐receptor showed agonist effect (analgesic effect) without neurotoxicity 4 . Post cesarean delivery pain was usually ranked moderate to severe, and sufentanil (SUF), a selective synthetic μ‐opioid agonist, has been used intravenously and intrathecally for the patients with pain of moderate‐to‐severe intensity for decades 12,13 . Recently, DEX combined with NAL or SUF has been studied during the perioperative period 14,15 .…”

“…4 Post cesarean delivery pain was usually ranked moderate to severe, and sufentanil (SUF), a selective synthetic μ-opioid agonist, has been used intravenously and intrathecally for the patients with pain of moderate-to-severe intensity for decades. 12,13 Recently, DEX combined with NAL or SUF has been studied during the perioperative period. 14,15 However, no comparable data have been shown regarding to these combinations in PCIA for post cesarean delivery analgesia.…”

Moxibustion for uterine contraction pain: A protocol for systematic review and meta-analysis

“…[5] Some studies have reported that the incidence of uterine contraction pain is 30% to 40% among women in labor, [6] and 4% to 10% of women in normal labor may experience chronic pain. [7] Uterine contractions are associated with the elimination of malignant fluid and regeneration of the uterus. As the global population is gradually decreasing, women’s fertility and health are highly valued, and uterine contraction is a necessary part of every woman’s life, so uterine contraction pain should be taken seriously.…”