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Intrathecal sufentanil as the sole agent in combined spinal-epidural analgesia for the ambulatory parturient

  • Alex Tiong Heng Sia
  • Jin Long Chong
  • Dicky Hock Beng Tay
  • Wai Kit Lo
  • Lin Han Chen
  • Jen Wun Chiu
Reports of Investigation

Abstract

Purpose

To compare the effect of a combination of intrathecal (IT) sufentanil plus bupivacaine with IT sufentanil alone, on the incidence of hypotension and the success of ambulation in parturients.

Methods

This was a controlled, double-blind prospective trial involving 50 parturients in early labour who had received combined spinal-epidural analgesia (CSE). They were divided equally into two groups; group A received 10 μg IT sufentanil while group B received IT 10 μg sufentanil plus 2.5 mg plain bupivacaine. The blood pressure, pain scores, the highest sensory block and the degree of motor blockade were documented over the first 30 min by an unbiased anaesthetist. The ability and the desire to ambulate was studied 30 min after CSE. The side effects were documented throughout labour.

Results

Group B had a higher incidence of hypotension; (12vs 3:P < 0.01). Fewer parturients in group B could ambulate (19vs 25:P < 0.05). Group B also had a higher sensory blockade than group A (median T4 vs T7–8:P < 0.01). Of all the 44 parturients who could ambulate, 13 desired not to do so, usually due to sedation.

Conclusion

The quality of analgesia in all subjects in the study was excellent. Side effects were more common in the IT sufentanil-bupivacaine combination group.

Keywords

Pain Score Bupivacaine Epidural Analgesia Sufentanil Motor Block 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Objectif

Comparer l’effet d’une combinaison de sufentanil intrathécal (IT) et de bupivacaïne avec le sufentanil IT employé seul, sur l’incidence de l’hypotension et le succès de la déambulation chez des parturientes.

Méthode

Cet essai prospectif, contrôlé et en double aveugle porte sur 50 parturientes, en début de travail, qui ont reçu une analgésie rachidienne et péridurale combinée (RPC). Elles ont été réparties également en deux groupes; le groupe A a reçu 10μg de sufentanil IT pendant que le groupe B a reçu 10μg de sufentanil IT plus 2,5 mg de bupivacaïne simple. La tension artérielle, le score de la douleur, le bloc sensitif le plus haut et le degré de blocage moteur ont été vérifiés pendant les 30 premières minutes par un anesthésiste impartial. La capacité de marcher et le désir de le faire ont été étudiés 30 minutes après la RPC. Les effets secondaires ont été vérifiés tout au long du travail.

Résultats

Le groupe B a présenté une plus grande incidence d’hypotension (12vs 3:P < 0,01). Moins de parturientes dans le groupe B ont pu marcher (19 vs 25:P < 0,05). Le groupe B présentait aussi un blocage sensitif plus haut que le groupe A (médiane T4 vs T7–8:P < 0,01). Des 44 parturientes qui pouvaient marcher, 13 n’ont pas voulu le faire, en général à cause de la sédation.

Conclusion

La qualité de l’analgésie chez tous les sujets de l’étude a été excellente. Les effets secondaires ont été plus fréquents dans le groupe ayant reçu la combinaison de sufentanil IT-bupivacaïne.

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Copyright information

© Canadian Anesthesiologists 1998

Authors and Affiliations

  • Alex Tiong Heng Sia
    • 1
  • Jin Long Chong
    • 1
  • Dicky Hock Beng Tay
    • 1
  • Wai Kit Lo
    • 1
  • Lin Han Chen
    • 1
  • Jen Wun Chiu
    • 1
  1. 1.Departments of Anaesthesia and Maternal and Fetal MedicineKandang Kerbau Women And Childrens HospitalSingapore

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