Sufentanil added to hyperbaric bupivacaine for subarachnoid block in Caesarean section

et al. 2012

Korean J Anesthesiol

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.

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

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

Bang

Chung

et al. 2012

Korean J Anesthesiol

“…The duration of effective analgesia is improved by the addition of sufentanil 5.0 and 7.5 µg according to Braga Ade et al [18] and it is effectively prolonged by the addition of sufentanil 1.5, 2.5 and 5.0 µg. Comparison of fentanyl and sufentanil [2] demonstrated that the duration of effective analgesia was significantly increased in the sufentanil 2.5 and 5.0 µg groups in contrast with that of the control group and the fentanyl 10 µg group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of fentanyl and sufentanil added to 0.5% hyperbaric bupivacaine for spinal anesthesia in patients undergoing cesarean section

Chung

et al. 2011

Korean J Anesthesiol

BackgroundSubarachnoid block is widely used for cesarean section due to the rapid induction, the complete analgesia, the low failure rate and the prevention of aspiration pneumonia. The addition of intrathecal opioids to local anesthetics seems to improve the quality of analgesia & prolong the duration of analgesia. Therefore we compared the effects of fentanyl 20 µg and sufentanil 2.5 µg, which were added to intrathecal hyperbaric bupivacaine.MethodsSeventy two healthy term parturients were randomly divided into three groups: Group C (control), Group F (fentanyl 20 µg) and Group S (sufentanil 2.5 µg). In every group, 0.5% heavy bupivacaine was added according to the adjusted dose regimen by Harten et al. We observed the maximal level of the sensory block and motor block, the quality of intraoperative analgesia, the duration of effective analgesia and the side effects.ResultsThere were significant differences between the control and the fentanyl 20 µg and sufentanil 2.5 µg groups for the degree of muscle relaxation, the quality of intraoperative analgesia, the maximal sedation level and the duration of effective analgesia. The frequencies of side effects such as nausea and pruritis in the opioid groups were higher than those in the control group. But there were no differences between fentanyl 20 µg and sufentanil 2.5 µg for the frequencies of nausea and pruritis.ConclusionsThe addition of fentanyl 20 µg or sufentanil 2.5 µg for spinal anesthesia provides adequate intraoperative analgesia without significant adverse effects on the mother and neonate.

“…We used a slightly higher dosage of intrathecal sufentanil to reduce local anaesthetic requirement and to provide prolonged analgesia, and our patient did not require any epidural top-ups during the surgery 70. This may be advantageous as compared to the use of intrathecal fentanyl, where frequent top ups were required 26,42.…”

Section: Discussionmentioning

confidence: 97%

Case Report and Mini Literature Review: Anesthetic Management for Severe Peripartum Cardiomyopathy Complicated with Preeclampsia Using Sufetanil in Combined Spinal Epidural Anesthesia

Bhakta

Mishra

Bakshi³

et al. 2011

Yonsei Med J

Peripartum cardiomyopathy (PPCM) is a rare entity, and anesthetic management for cesarean section of a patient with this condition can be challenging. We hereby present the anesthetic management of a patient with PPCM complicated with preeclampsia scheduled for cesarean section, along with a mini review of literature. A 24 year-old primigravida with twin gestation was admitted to our hospital with severe PPCM and preeclampsia for peripartum care, which finally required a cesarean section. Preoperative optimization was done according to the goal of managing left ventricular failure. Combined spinal epidural (CSE) anaesthesia with bupivacaine and sufentanil was used for cesarean section under optimal monitoring. The surgery was completed without event or complication. Postoperative pain relief was adequate and patient required only one epidural top up with sufentanil 6 hours after operation. To the best of our knowledge there is no report in literature of the use of sufentanil as a neuraxial opioid in the anesthetic management of cesarean section in a patient with PPCM. CSE with sufentanil may be a safer and more effective alternative in such cases.