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Intrathecal sufentanil decreases the median effective dose (ED50) of intrathecal hyperbaric ropivacaine for caesarean delivery.
Acta Anaesthesiol Scand. 2010 Mar; 54(3):284-90.AA

Abstract

BACKGROUND

The addition of opioid to local anaesthetics has become a well-accepted practice of spinal anaesthesia for caesarean delivery. Successful caesarean delivery anaesthesia has been reported with the use of a low dose of intrathecal hyperbaric ropivacaine coadministered with sufentanil. This prospective, double-blinded study determined the median effective dose (ED50) of intrathecal hyperbaric ropivacaine with and without sufentanil for caesarean delivery, to quantify the sparing effect of sufentanil on the ED50 of intrathecal hyperbaric ropivacaine.

METHODS

Sixty-four parturients undergoing elective caesarean delivery with combined spinal-epidural anaesthesia were randomized into two groups: Group R (ropivacaine) and Group RS (ropivacaine plus sufentanil 5 microg). The initial dose of ropivacaine was 13 mg in Group R and 10 mg in Group RS. The effective dose was defined as a T(6) level attained within 10 min and no supplemental epidural anaesthetic required during surgery. Effective or ineffective responses determined, respectively, a 0.3 mg decrease or increase of the dose of ropivacaine for the next patient using an up-down sequential allocation.

RESULTS

The ED50 of intrathecal ropivacaine was 11.2 mg [confidence interval (CI) 95%: 11.0-11.6] in Group R vs. 8.1 mg (CI 95%: 7.8-8.3) in Group RS. Motor block was markedly more intense in Group R than in Group RS, and the incidence of shivering was lower in Group RS than in Group R. There were no differences in the onset time of sensory block or motor block, in the incidence of hypotension, nausea and vomiting.

CONCLUSION

Intrathecal sufentanil 5 microg produced a 28% reduction of ED50 of intrathecal hyperbaric ropivacaine for caesarean delivery.

Authors+Show Affiliations

Department of Anaesthesia, Women's Hospital, School of Medicine, Zhejiang University, Zhejiang 310006, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19650804

Citation

Chen, X, et al. "Intrathecal Sufentanil Decreases the Median Effective Dose (ED50) of Intrathecal Hyperbaric Ropivacaine for Caesarean Delivery." Acta Anaesthesiologica Scandinavica, vol. 54, no. 3, 2010, pp. 284-90.
Chen X, Qian X, Fu F, et al. Intrathecal sufentanil decreases the median effective dose (ED50) of intrathecal hyperbaric ropivacaine for caesarean delivery. Acta Anaesthesiol Scand. 2010;54(3):284-90.
Chen, X., Qian, X., Fu, F., Lu, H., & Bein, B. (2010). Intrathecal sufentanil decreases the median effective dose (ED50) of intrathecal hyperbaric ropivacaine for caesarean delivery. Acta Anaesthesiologica Scandinavica, 54(3), 284-90. https://doi.org/10.1111/j.1399-6576.2009.02051.x
Chen X, et al. Intrathecal Sufentanil Decreases the Median Effective Dose (ED50) of Intrathecal Hyperbaric Ropivacaine for Caesarean Delivery. Acta Anaesthesiol Scand. 2010;54(3):284-90. PubMed PMID: 19650804.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrathecal sufentanil decreases the median effective dose (ED50) of intrathecal hyperbaric ropivacaine for caesarean delivery. AU - Chen,X, AU - Qian,X, AU - Fu,F, AU - Lu,H, AU - Bein,B, Y1 - 2009/07/22/ PY - 2009/8/5/entrez PY - 2009/8/5/pubmed PY - 2010/7/16/medline SP - 284 EP - 90 JF - Acta anaesthesiologica Scandinavica JO - Acta Anaesthesiol Scand VL - 54 IS - 3 N2 - BACKGROUND: The addition of opioid to local anaesthetics has become a well-accepted practice of spinal anaesthesia for caesarean delivery. Successful caesarean delivery anaesthesia has been reported with the use of a low dose of intrathecal hyperbaric ropivacaine coadministered with sufentanil. This prospective, double-blinded study determined the median effective dose (ED50) of intrathecal hyperbaric ropivacaine with and without sufentanil for caesarean delivery, to quantify the sparing effect of sufentanil on the ED50 of intrathecal hyperbaric ropivacaine. METHODS: Sixty-four parturients undergoing elective caesarean delivery with combined spinal-epidural anaesthesia were randomized into two groups: Group R (ropivacaine) and Group RS (ropivacaine plus sufentanil 5 microg). The initial dose of ropivacaine was 13 mg in Group R and 10 mg in Group RS. The effective dose was defined as a T(6) level attained within 10 min and no supplemental epidural anaesthetic required during surgery. Effective or ineffective responses determined, respectively, a 0.3 mg decrease or increase of the dose of ropivacaine for the next patient using an up-down sequential allocation. RESULTS: The ED50 of intrathecal ropivacaine was 11.2 mg [confidence interval (CI) 95%: 11.0-11.6] in Group R vs. 8.1 mg (CI 95%: 7.8-8.3) in Group RS. Motor block was markedly more intense in Group R than in Group RS, and the incidence of shivering was lower in Group RS than in Group R. There were no differences in the onset time of sensory block or motor block, in the incidence of hypotension, nausea and vomiting. CONCLUSION: Intrathecal sufentanil 5 microg produced a 28% reduction of ED50 of intrathecal hyperbaric ropivacaine for caesarean delivery. SN - 1399-6576 UR - https://www.unboundmedicine.com/medline/citation/19650804/Intrathecal_sufentanil_decreases_the_median_effective_dose__ED50__of_intrathecal_hyperbaric_ropivacaine_for_caesarean_delivery_ DB - PRIME DP - Unbound Medicine ER -