Sufentanil For Labor Analgesia Research Articles

Transplacental transfer and neonatal influences of sonophoretically administered sufentanil versus epidural sufentanil in labor peridural analgesia: A randomized prospective double-blind contemplate

BackgroundLabor sufentanil impact on the newborn is debatable. This randomized double-blind investigation examined the transplacental conveyance and neonatal influences of sonophoretic versus epidural sufentanil for labor analgesia and its outcome on breast-feeding.Methods60 Healthy parturient women receiving labor epidural analgesia were enrolled in the study. They were administered epidural bupivacaine (12-ml bolus then 10 ml/h of 0.125%) solely (Group I, n = 20) or with sonophoretically transdermally administered sufentanil (Group II, n = 20) or with epidurally administered sufentanil (Group III, n = 20). Sufentanil received by Groups II and III was 15 μm followed by 10 ml/h of 0.25 μm/ml solution.ResultsSufentanil was detected in five umbilical arterial (UA) samples in Group III versus in two UA samples in Group II. Neonatal Neurologic and Adaptive Capacity Score (NACS) at 24 h was lowest in Group III (P = 0.04). On postpartum day 1, Group III women reported breast-feeding difficultly (25%) more oftentimes than Group II women (10%), or Group I women (5%) (P = 0.05). There was 45% breast-feeding difficulty in each group according to lactation consultant’s assessment (P = 1.0). At 6 weeks postpartum, more Group III women were not breast-feeding (35%) than Group II women (10%) or Group I (10%) (P = 0.004).ConclusionSufentanil transplacental transport and fetal exposure appeared greater in epidural than in sonophoretic sufentanil. The former group women were facing more difficulty at starting breast-feeding on postpartum day 1 and were more apt to have stopped breast-feeding 6 weeks postpartum than the latter group women.

Clinical effects of continuous spinal anesthesia with sufentanil for labor analgesia

Objective To evaluate the clinical effects of continuous spinal anesthesia (CSA) with sufentanil for labor analgesia when compared with the effects of combined spinal-epidural analgesia (CSEA) and continuous epidural analgesia (CEA).Methods One hundred ASA Ⅰ or Ⅱ nulliparous patients who were at full term and who requested labor epidural analgesia,were randomly divided into 3 groups (n =40 each):continuous spinal analgesia group (group S),combined spinal-epidural analgesia group (group C) and continuous epidural analgesia group (group E).Labor analgesia was performed when the cervical dilation was 2-3 cm.In group S,the spinal catheter was placed at L3,4 interspace,and patient-controlled analgesia (PCA) with sufentanil was performed after a loading dose of sufentarnil 8 μg.PCA solution contained sufentanil 100 μg in 100 ml of normal saline.The PCA pump was set up with a 2 ml bolus dose,a 10 min lockout interval (volume was limited to 14 ml/h) and background infusion at a rate of 2 ml/h.In group C,CSEA was performed at L2,3 interspace,the patients received intrathecal sufentanil 8 μg via a spinal needle,the PCA solution contained 0.1％ ropivacaine 200 mg and 0.5 μg/ml sufentanil 100 μg in 200 ml of normal saline.The CSEA pump was set up with a 6 ml bolus dose,a 10 min lockout interval (volume was limited to 40 ml/h) and background infusion at a rate of 6 ml/h.In group E,CEA was performed at L2,3 interspace and the method was the same as in group C.The systolic pressure,diastolic pressure,HR,fetal heart rate (FHR) and intensity of uterine contraction were recorded beforeanalgesia and 5,10,15,30,60 and 120 min after beginning of analgesia,when the cervical dilation was 7-8 cm,and when the uterine cervix dilated absolutely.The side effects were recorded.Bromage scale was assessed at 10 min of analgesia.Apgar scores of the neonates were recorded at 1,5 and 10 min after birth.The analgesic effect was evaluated 24 h after birth.Results In group S,the hemodynamic parameters,FHR and intensity of uterine contraction were within the normal range,the analgesic effect was excellent or good,Bromage scale was 0,two cases had post-dural puncture headache,the incidence of pruritus was 42 ％ and pruritus was mild,Apgar scores of the neonates were 9.1 ± 0.4,9.6 ± 0.4 and 10 at 1,5 and 10 min after birth,respectively,no cardiovascular events occurred.There was no significant difference in the parameters mentioned above between groups C and S and between groups E and S (P ＞ 0.05).Conclusion CSA with sufentail is effective and suitable for labor analgesia and the efficacy is comparable with that of CSEA and CEA. Key words: Subarachnoid space; Sufentanil; Parturition; Analgesia

Journal-related Activities at the 2003 American Society of Anesthesiologists Annual Meeting

Journal-related Activities at the 2003 American Society of Anesthesiologists Annual Meeting

A Comparison of Intrathecal Fentanyl and Sufentanil for Labor Analgesia

A Comparison of Intrathecal Fentanyl and Sufentanil for Labor Analgesia

A Dose Response of Intrathecal Epinephrine Combined with Bupivacaine and Sufentanil for Labor Analgesia.

A Dose Response of Intrathecal Epinephrine Combined with Bupivacaine and Sufentanil for Labor Analgesia.

Intrathecal Clonidine Combined with Sufentanil for Labor Analgesia

GAUTIER, PHILIPPE E.; KOCK, MARC DE; FANARD, LUC; STEENBERGE, ALBERT VAN; HODY, JEAN-LUC Author Information

Comparison of three different doses of intrathecal fentanyl and sufentanil for labor analgesia

Study Objective: To compare the duration of analgesia and incidence of side effects of three doses of intrathecal fentanyl (25 μg, 37.5 μg, 50 μg) with three doses of intrathecal sufentanil (5 μg, 10 μg, 15 μg). Design: Randomized, double-blind study. Setting: Labor suite of the Hospital of the University of Pennsylvania Patients: 60 ASA physical status I and II parturients in active labor who requested analgesia. Interventions: Patients received one of the six doses of opioid diluted with normal saline to achieve a volume of 1.5 ml intrathecally. Measurements and Main Results: Duration of analgesia, contraction pain, degree of pruritus, maternal blood pressure, maternal heart rate, fetal heart rate, Apgar scores, and neurologic and adaptive capacity scores were measured. There was no statistical difference among the doses of fentanyl in duration of analgesia. In addition, there was no statistical difference among the doses of sufentanil. The durations of analgesia for all doses of sufentanil were statistically longer than that for all doses of fentanyl. There was no difference among all the groups for maximal pruritus score. The duration of pruritus did not differ among doses of fentanyl or sufentanil; the duration of pruritus was significantly longer for sufentanil. All groups had a decrease in blood pressure. There was no difference among the groups in regard to the effect on the systolic or diastolic blood pressure. Conclusions: Intrathecal sufentanil produced analgesia of longer duration than fentanyl for all doses studied. The duration of pruritus with sufentanil was also longer.

Intrathecal Ropivacaine for Labor Analgesia

Ropivacaine has less potential for central nervous system and cardiovascular toxicity than bupivacaine; in pregnant patients and volunteers, it produces less motor block in equianalgesic doses than bupivacaine.We compared two doses of intrathecal ropivacaine combined with sufentanil with a standard dose of intrathecal bupivacaine plus sufentanil for labor analgesia using a combined spinal-epidural (CSE) technique. In a prospective, randomized, double-blind fashion, 48 patients requesting labor analgesia received either 2.5 mg of intrathecal bupivacaine plus sufentanil 10 [micro sign]g (B), 2 mg of intrathecal ropivacaine plus sufentanil 10 [micro sign]g (R2), or 4 mg of intrathecal ropivacaine plus sufentanil 10 [micro sign]g (R4). Duration of analgesia and side effects, such as motor block, pruritus, hypotension, ephedrine requirements and fetal bradycardia, were recorded. Duration of analgesia (mean +/- SD) was 79 +/- 30 min for R2, 98 +/- 19 min for R4, and 92 +/- 38 min for B (P = not significant). No differences in motor block or side effects were detected among the groups. We conclude that ropivacaine, when combined with sufentanil, is effective for providing CSE labor analgesia and offers no advantage over bupivacaine in the studied doses. Implications: In this study, we compared a standard dose of intrathecal bupivacaine with sufentanil for combined spinal epidural analgesia with two doses of the new local anesthetic ropivacaine. Both local anesthetics provided similar labor analgesia duration with equivalent side effect profiles in the doses studied. (Anesth Analg 1998;87:624-7)

Intrathecal Sufentanil for Labor Analgesia???Sensory Changes, Side Effects, and Fetal Heart Rate Changes

This study was designed to evaluate intrathecal (IT) sufentanil for labor analgesia with respect to sensory changes, side effects, and fetal heart rate (FHR) changes. In Phase I of the study, data regarding duration of analgesia and hemodynamic changes were obtained retrospectively from the labor and anesthetic records of 90 patients who had received IT sufentanil, 10 micrograms in 1 mL of saline, during active labor. In Phase II, an additional 18 parturients who received similar treatment were studied prospectively to document sensory, motor, and hemodynamic changes, as well as the incidence of side effects. In Phase I, analgesia occurred rapidly and lasted 124 +/- 68 min (SD); 19% of patients required no further analgesia before delivery. In Phase II, median time to onset of analgesia was 3 min (range 1-6 min) and mean duration of analgesia was 96 +/- 36 min. Decreased sensation to pinprick and cold occurred within 6 min extending from T4 to L4 (upper and lower median levels) in the majority of patients. All subjects requested additional analgesia within approximately 30 min of recession of sensory changes. Motor strength remained normal throughout. Hypotension (systolic blood pressure [BP] < or = 90 mm Hg or > 20% decrease in systolic BP) occurred in 14% and 11% of patients in Phase I and II, respectively. Perineal itching preceded analgesia in 95% of patients and all subjects experienced mild sedation. FHR changes occurred in 15% of cases but were not associated with adverse neonatal outcome.(ABSTRACT TRUNCATED AT 250 WORDS)