Dose-response relationship of bupivacaine coadministered with sufentanil for subarachnoid block in severely preeclamptic patients undergoing cesarean delivery

Abstract

Objective To determine the dose-response relationship of bupivacaine coadministered with sufentanil for subarachnoid block in severely preeclamptic patients undergoing cesarean delivery. Methods Two hundred patients with severe preeclampsia, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, scheduled for elective cesarean delivery, were divided into 4 groups(n=50 each)using a random number table: bupivacaine 4 mg group(group B4), bupivacaine 6 mg group(group B6), bupivacaine 8 mg group(group B8), and bupivacaine 10 mg group(group B10). In B4, B6, B8 and B10 groups, bupivacaine 4, 6, 8 and 10 mg plus 2.5 μg sufentanil in 2.5 ml of normal saline were injected into the subarachnoid space, respectively.Effective anesthesia was defined as bilateral sensory block of T6 achieved at 10 min after intrathecal administration when measured by pin-prick test, and with no need for epidural supplementation(lidocaine). A probit analysis was used to estimate the 50% effective dose(ED50)and 95% effective dose(ED95)with 95% confidence intervals for bupivacaine, coadministered with sufentanil, when used for subarachnoid block in severely preeclamptic patients underwent cesarean delivery. Results When coadministered with sufentanil, the ED50 and ED95(95% confidence interval)of bupivacaine were 5.67(5.20-6.10)mg and 8.82(8.14-9.87)mg, respectively, for subarachnoid block in severely preeclamptic patients underwent cesarean delivery. Conclusion The ED50 and ED95 of bupivacaine for subarachnoid block, when coadministered with sufentanil 2.5 μg, are 5.67 and 8.82 mg, respectively, in severely preeclamptic patients undergoing cesarean delivery. Key words: Bupivacaine; Sufentanil; Dose-response relationship, drug; Eclampsia; Anesthesia, spinal; Cesarean section