The Effect of Intrathecal Bupivacaine Mixed with Sufentanil for Labor Analgesia / 대한마취과학회지

BACKGROUND: The combination of a local anesthetic and an opioid has been shown to produce effective epidural labor analgesia. It was reported that the combination of intrathecal opioid and bupivacaine could produce labor analgesia with longer duration and less side effects. This study was done to evaluate the effect of intrathecal bupivacaine mixed with sufentanil for labor analgesia. METHODS: Eighty women requesting labor analgesia were randomly assigned to receive intrathecal 10 mcg of sufentanil (S group, n = 40) or 2.5 mg of bupivacaine plus 10 microgram of sufentanil (SB group, n = 40) diluted in a total volume of 2.2 ml with normal saline. The analgesia was performed using combined spinal-epidural technique in the lateral position. Visual analogue scales (VAS) for pain, sensory changes to cold, duration of analgesia, motor block, hypotension, fetal heart rate, pruritus, and other side effects were assessed for 30 minutes after intrathecal drug injection. RESULTS: There were no significant differences in the VAS pain scores and sensory levels at 5 minutes after intrathecal drug injection between groups. However, VAS pain scores were significantly lower and sensory levels higher in the SB group at 15 minutes and 30 minutes after intrathecal drug injection. The duration of analgesia provided by intrathecal sufentanil (n = 31) was 103.4 41.1 min, by intrathecal sufentanil plus bupivacaine (n = 29) 113.0 32.1 min (P = 0.30). Motor block assessed by a modified Bromage scale was significantly frequent in the SB group (P< 0.001). Not only adverse effects such as hypotension, fetal bradycardia, pruritus, and nausea, but also satisfaction scores were similar in both groups. CONCLUSIONS: The addition of bupivacaine to intrathecal sufentanil produced more frequent motor block and extensive sensory block, but better analgesia. However, duration of analgesia, side effects and satisfaction score did not change.

The Comparison of Dose Related Efficacy and Side Effects of Intrathecal Sufentanil in Labor Analgesia / 대한마취과학회지

BACKGROUND: There are quite a few studies examining the relative efficacy of different doses of intrathecal sufentanil for labor analgesia. The authors designed this prospective, randomized, double blind study to compare the efficacy and side effects of 5 and 10 microgram intrathecal sufentanil. METHODS: Forty healthy, laboring, term parturients, in the active phase of labor participated in this study. In a randomized, double-blind fashion, patients received 5 or 10 microgram intrathecal sufentanil as a part of combined spinal-epidural technique. Scores of pain, itching, nausea, and sedation were taken on visual analog scales before and every 10 minutes after drug injection for one hour. We also recorded maternal blood pressure, respiratory rate and peripheral oxygen saturation during the same time period. RESULTS: Both doses of sufentanil provided adequate analgesia. Although 10 microgram sufentanil produced a slightly more profound analgesia, the duration of pain relief did not differ between the two groups. Both drug doses were associated with significant increase in itching. The 10 microgram dose was associated with more sedation and a greater decrease in arterial oxygen saturation (SaO2). CONCLUSIONS: Both 5 and 10 microgram intrathecal sufentanil provided adequate labor analgesia. Both doses were associated with increased spinal (itching) and supraspinal (sedation, respiratory depression) side effects, the intensity of which appeared to be more profound in the 10 microgram group.

The Comparison of Dose Related Efficacy and Side Effects of Intrathecal Sufentanil in Labor Analgesia / 대한마취과학회지

BACKGROUND: There are quite a few studies examining the relative efficacy of different doses of intrathecal sufentanil for labor analgesia. The authors designed this prospective, randomized, double blind study to compare the efficacy and side effects of 5 and 10 microgram intrathecal sufentanil. METHODS: Forty healthy, laboring, term parturients, in the active phase of labor participated in this study. In a randomized, double-blind fashion, patients received 5 or 10 microgram intrathecal sufentanil as a part of combined spinal-epidural technique. Scores of pain, itching, nausea, and sedation were taken on visual analog scales before and every 10 minutes after drug injection for one hour. We also recorded maternal blood pressure, respiratory rate and peripheral oxygen saturation during the same time period. RESULTS: Both doses of sufentanil provided adequate analgesia. Although 10 microgram sufentanil produced a slightly more profound analgesia, the duration of pain relief did not differ between the two groups. Both drug doses were associated with significant increase in itching. The 10 microgram dose was associated with more sedation and a greater decrease in arterial oxygen saturation (SaO2). CONCLUSIONS: Both 5 and 10 microgram intrathecal sufentanil provided adequate labor analgesia. Both doses were associated with increased spinal (itching) and supraspinal (sedation, respiratory depression) side effects, the intensity of which appeared to be more profound in the 10 microgram group.