Low-dose naloxone combined with sufentanil and ropivacaine for postoperative patient-controlled epidural analgesia in elderly patients undergoing total hip replacement

Abstract

Objective:To evaluate the effect and safety of low-dose naloxone combined with sufentanil and ropivacaine for postoperative patient-controlled epidural analgesia(PCEA)in elderly patients undergoing total hip replacement.Methods:A total of 60 elderly patients(ASAⅠ-Ⅱ)undergoing total hip replacement were randomly assigned to two equal groups:Group C was given 0.5 μg/ml sufentanil in 0.15% ropivacaine;Group N was given the same solution with 0.09 μg/(kg·ml)naloxone.The 2 groups were followed up in a double-blinded manner:the visual analogue scale(VAS)for pain score was recorded at 2,6,12,and 24 h to evaluate the analgesia effect.Meanwhile,the incidences of postoperative nausea and vomiting(PONV),pruritus,sedation,respiratory depression,and hypotension were also recorded.Results:The VAS pain score in Group N was significantly lower than that in Group C at 6,12 and 24 h(P0.01).The incidence of PONV in Group N was significantly lower than that in Group C(P0.05);the incidences of other opioid-induced side-effects were not significantly different between the 2 groups.During the course of analgesia,the vital signs of 2 groups were stable;no patients had respiratory depression or hypotension.Conclusion:Low-dose epidural naloxone can enhance the analgesic effect of sufentanil.With timely postoperative monitoring,low-dose naloxone combined with sufentanil and ropivacaine is safe and effective for postoperative patient-controlled epidural analgesia in elderly patients undergoing total hip replacement.