Abstract
Epidural sufentanil was administered to 57 women after Caesarean section, under epidural anaesthesia, to provide postoperative analgesia. Each patient received a 30 μg dose at the first complaint of pain and this dose was repeated when pain recurred. Epinephrine (1:200,000) was added to the local anaesthetic, sufentanil, both, or neither. The time of onset of analgesia, efficacy, duration of analgesia and the incidence of side-effects were recorded. This dose of epidural sufentanil provided satisfactory postoperative analgesia and no serious side-effects were observed. The onset of analgesia was rapid (4–6 min), but the duration of action was brief (4–5 hr). The addition of 1:200,000 epinephrine had no statistically significant influence on any of the measured variables. Pruritus occurred commonly but never required treatment. Drowsiness was experienced frequently and was felt by some patients to inhibit their interaction with their neonates. Respiratory depression, as defined by a respiratory rate less than 10 bpm, was not observed. A number of patients noted a transient period of euphoria 5–8 min after administration of the epidural sufentanil. The authors feet that epidural sufentanil provides satisfactory analgesia after Caesarean section, but the brief duration of action and the high incidence of drowsiness limit its acceptability for routine use in obstetric patients.
Résumé
Le sufentanil en injection epidurale fut administré à 57 femmes après césarienne pour l’analgésie postopératoire. Chaque patiente a recu 30 μg lors de la première douleur et cette dose fut répétée quand la douleur est revenue. L’épinéphrine (1:200,000) fut ajouté à l’anesthésie locale, le sufentanil, au deux, ou à aucun. Le temps d’installation d’analgésie, l’efficacité, la durée de l’analgésie et l’insuffisance des effets secondaires furent enregistrés. Cette dose de sufentanil en injection épidurale a fourni une analgésie postopératoire satisfaisante et aucun effet secondaire fut observé. Le début de l’analgésie fut rapide (4–6 min), mais la durée d’action fut brève (4–5 hre). L’addition de 1:200,000 épinéphrine n’a eu aucune influence statistiquement significative sur aucune des mesures éludiées. Le prurit fut le plus communément observé mais n’a jamais requis un traitement. La somnolence fut observée fréquemment et certaines patientes l’attachait en la diminution de leur interaction avec les nouveau-nés. La dépression respiratoire définie par une fréquence respiratoire inférieure à 10 resp/min ne fut pas observée. Un certain nombre de patientes out noté une période transitoire d’euphorie de cinq à huit minutes après l’administration de sufentanil en injection épidurale. Les auteurs pensent que le sufentanil en injection épidurale fournit une analgésie satisfaisante après une césarienne mais une durée d’action courte et la haute incidence de somnolence limitent son acceptabilité de routine pour les patientes en obstétrique.
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This study was supported by a grant from Janssen Pharmaceutica.
An erratum to this article is available at http://dx.doi.org/10.1007/BF03006554.
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McMorland, G.H., Douglas, M.J., Kim, J.H.K. et al. Epidural sufentanil for post-Caesarean section analgesia: lack of benefit of epinephrine. Can J Anaesth 37, 432–437 (1990). https://doi.org/10.1007/BF03005621
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DOI: https://doi.org/10.1007/BF03005621