Purpose
We compared the effects of different doses of intrathecal sufentanil when administered together with hyperbaric bupivacaine for elective caesarean section.
Methods
This was a prospective, randomized, double-blind, controlled trial involving 100 pregnant women, American Society of Anesthesiologists (ASA) I-II, who were scheduled for elective caesarean section under spinal anesthesia. The patients were assigned to four groups according to the dose of sufentanil used: no sufentanil (group I; placebo) or 1.5, 2.5, or 5.0 µg sufentanil (groups 2–4, respectively). In every group, the local anesthetic used was hyperbaric bupivacaine 0.5% (12.5 mg), and the total volume of the solution was 3.5 ml. The duration of complete analgesia, maternal side effects, and maternal/fetal outcomes were recorded. The duration of complete analgesia was defined as the time from intrathecal injection to a vernal analogue score (VAS) of more than 0.
Results
No patient experienced intraoperative pain. The duration of complete analgesia was prolonged in all groups receiving opioids. The duration of the analgesia and the 0- to 6-h intravenous analgesic requirements were similar in the sufentanil groups. Moreover, the sufentanil groups had longer durations of complete analgesia than the placebo group. Pruritus was more frequent in the 2.5- and 5-µg sufentanil groups than in the 1.5-µg sufentanil and placebo groups. There were no differences among the groups in umbilical cord blood gases on in neonatal Apgar scores.
Conclusion
The addition of sufentanil 1.5 and 2.5 µg to hyperbaric bupivacaine provided adequate anesthesia for caesarean delivery and good postoperative analgesia. In addition, the incidence of pruritus was significantly lower in the 1.5-µg sufentanil group when compared with that in the 2.5- and 5-µg groups.