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Low dose intrathecal ropivacaine with or without sufentanil provides effective analgesia and does not impair motor strength during labour: a pilot study.
Can J Anaesth. 2001 Jul-Aug; 48(7):677-80.CJ

Abstract

PURPOSE

Although ropivacaine has been used to provide spinal anesthesia in the surgical population, its intrathecal administration for labour analgesia has only recently been described. We evaluated the effects of low dose intrathecal ropivacaine with or without sufentanil for labour analgesia.

METHODS

Thirty-six term parturients in active labour were randomly assigned to receive 3 mg of intrathecal ropivacaine (group R) or 3 mg ropivacaine with 10 microg of sufentanil (group RS). Patients were evaluated by a blinded observer for hypotension, linear analogue score (VAS 0-100) for labour pain, motor power in the lower limbs, onset of analgesia, sensation to cold and pin prick, duration of analgesia, and neonatal Apgar scores. The following day patients were assessed for satisfaction, headache and neurologic deficit.

RESULTS

The mean duration of analgesia in the R group was 41.4 +/- 4.9 min and 95.0 +/- 6.1 min in the RS group (mean +/- SEM, P=0.0001). All subjects had satisfactory analgesia at five minutes, although analgesia from the ropivacaine- sufentanil combination was superior to that provided by ropivacaine alone. Total duration of labour was no different between the groups (R- 306 +/- 34, RS- 384 +/- 44 min, P=0.17). No patient showed evidence of motor block. All patients were satisfied with the labour analgesia. No neurological complications were observed.

CONCLUSIONS

Low dose ropivacaine provides effective analgesia during labour via the intrathecal route. It can be mixed with sufentanil in the above-mentioned concentrations to improve both the quality and duration of analgesia. Fetal outcome remains favourable. It may provide minimal or no motor block, to facilitate ambulation.

Authors+Show Affiliations

Harvard Medical School, Department of Anesthesia Critical Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. aksoni@mediaone.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11495875

Citation

Soni, A K., et al. "Low Dose Intrathecal Ropivacaine With or Without Sufentanil Provides Effective Analgesia and Does Not Impair Motor Strength During Labour: a Pilot Study." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 48, no. 7, 2001, pp. 677-80.
Soni AK, Miller CG, Pratt SD, et al. Low dose intrathecal ropivacaine with or without sufentanil provides effective analgesia and does not impair motor strength during labour: a pilot study. Can J Anaesth. 2001;48(7):677-80.
Soni, A. K., Miller, C. G., Pratt, S. D., Hess, P. E., Oriol, N. E., & Sarna, M. C. (2001). Low dose intrathecal ropivacaine with or without sufentanil provides effective analgesia and does not impair motor strength during labour: a pilot study. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 48(7), 677-80.
Soni AK, et al. Low Dose Intrathecal Ropivacaine With or Without Sufentanil Provides Effective Analgesia and Does Not Impair Motor Strength During Labour: a Pilot Study. Can J Anaesth. 2001 Jul-Aug;48(7):677-80. PubMed PMID: 11495875.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low dose intrathecal ropivacaine with or without sufentanil provides effective analgesia and does not impair motor strength during labour: a pilot study. AU - Soni,A K, AU - Miller,C G, AU - Pratt,S D, AU - Hess,P E, AU - Oriol,N E, AU - Sarna,M C, PY - 2001/8/10/pubmed PY - 2001/10/5/medline PY - 2001/8/10/entrez SP - 677 EP - 80 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 48 IS - 7 N2 - PURPOSE: Although ropivacaine has been used to provide spinal anesthesia in the surgical population, its intrathecal administration for labour analgesia has only recently been described. We evaluated the effects of low dose intrathecal ropivacaine with or without sufentanil for labour analgesia. METHODS: Thirty-six term parturients in active labour were randomly assigned to receive 3 mg of intrathecal ropivacaine (group R) or 3 mg ropivacaine with 10 microg of sufentanil (group RS). Patients were evaluated by a blinded observer for hypotension, linear analogue score (VAS 0-100) for labour pain, motor power in the lower limbs, onset of analgesia, sensation to cold and pin prick, duration of analgesia, and neonatal Apgar scores. The following day patients were assessed for satisfaction, headache and neurologic deficit. RESULTS: The mean duration of analgesia in the R group was 41.4 +/- 4.9 min and 95.0 +/- 6.1 min in the RS group (mean +/- SEM, P=0.0001). All subjects had satisfactory analgesia at five minutes, although analgesia from the ropivacaine- sufentanil combination was superior to that provided by ropivacaine alone. Total duration of labour was no different between the groups (R- 306 +/- 34, RS- 384 +/- 44 min, P=0.17). No patient showed evidence of motor block. All patients were satisfied with the labour analgesia. No neurological complications were observed. CONCLUSIONS: Low dose ropivacaine provides effective analgesia during labour via the intrathecal route. It can be mixed with sufentanil in the above-mentioned concentrations to improve both the quality and duration of analgesia. Fetal outcome remains favourable. It may provide minimal or no motor block, to facilitate ambulation. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/11495875/Low_dose_intrathecal_ropivacaine_with_or_without_sufentanil_provides_effective_analgesia_and_does_not_impair_motor_strength_during_labour:_a_pilot_study_ L2 - https://doi.org/10.1007/BF03016202 DB - PRIME DP - Unbound Medicine ER -