Efficacy of sufentanil addition to ropivacaine epidural anaesthesia for Caesarean section

Abstract

This prospective double-blind trial evaluated the effect of sufentanil addition to epidural ropivacaine for elective Caesarean section. Sixty healthy parturients were randomly assigned to receive an initial dose of 90 mg of plain ropivacaine, or 90 mg of ropivacaine plus 10 or 20 microg of sufentanil (n = 20 each). Before surgery, if necessary, additional epidural ropivacaine was injected. Primary outcome parameter was time to achieve sensory block at T4. Time to reach the sensory block was remarkably reduced (P < 0.001 each) by addition of 10 or 20 microg of sufentanil (21 +/- 8 min, 15 +/- 5 min, 11 +/- 4 min in the plain ropivacaine, the 10- and 20-microg sufentanil groups, respectively) whereas the visual analogue scale (VAS) scores at delivery were significantly reduced (P = 0.028) only by 20 microg of sufentanil (32 +/- 35 mm in the plain ropivacaine vs. 9 +/- 19 mm in the 20-microg sufentanil groups). The total dose of ropivacaine was significantly lower (P = 0.005) in patients receiving 20 microg of sufentanil (100.5 +/- 15.0 mg) compared with those treated with plain ropivacaine (118.5 +/- 17.3 mg). The incidence of maternal side-effects (hypotension, bradycardia, nausea, vomiting, shivering, pruritus) and neonatal outcome [APGAR score, neurologic and adaptive capacity (NAC) score, umbilical cord blood-gas values] did not differ between the groups. Our results suggest that addition of 20 microg of sufentanil improved the epidural anaesthesia with ropivacaine 0.75% for Caesarean section.