Purpose: To determine the 90 percent effective dose (ED90) of intrathecal sufentanil combined with ropivacaine 2.5 mg for labor analgesia and observe its safety for parturients and neonates.
Methods: We conducted a prospective, double-blind, biased coin up-and-down study. We injected a fixed 2.5 mg ropivacaine combined with a designated dose of sufentanil intrathecally to observe the labor analgesic effect. The initial dose of sufentanil was assigned 1.0 μg, and the remaining doses were assigned as per the biased coin up-and-down method. The criterion of successful response was defined as VAS ≤ 30 mm after intrathecal injection at 10 min. Safety was evaluated in terms of maternal and neonatal outcomes.
Results: The ED90 dose of intrathecal sufentanil combined with ropivacaine 2.5 mg (0.1%, 2.5 mL) was 2.61 μg (95% CI, 2.44 to 2.70 μg) by isotonic regression. No respiratory depression, hypotension, or motor block was observed. Thirty-one (77.5%) parturients complained of pruritus, and 14 (35.0%) suffered nausea and vomiting. Three neonates reported a 1 min Apgar score of ≤7, and none reported a 5 min Apgar score of ≤7.
Conclusion: The ED90 of intrathecal sufentanil combined with ropivacaine 2.5 mg for labor analgesia was 2.61 μg. The dose is safe for parturients and neonates.
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http://dx.doi.org/10.3389/fmed.2023.1275605 | DOI Listing |
Pain Physician
December 2024
Department of Anesthesia, Jiaxing University Affiliated Women and Children Hospital, Jiaxing, China.
Background: Visceral pain is common in cesarean sections conducted under combined spinal-epidural anesthesia (CSE). Epidural volume extension (EVE) is a technique for enhancing the effect of intrathecal blocks by inducing epidural fluid boluses in the CSE. Whether EVE that uses different drugs can reduce visceral pain during cesarean sections is rarely studied.
View Article and Find Full Text PDFBr J Anaesth
June 2024
Department of Anesthesiology, Jiaxing Maternity and Children Health Care Hospital, Affiliated Women and Children Hospital of Jiaxing University, Jiaxing, Zhejiang, China.
Background: Dopamine antagonists, 5-HT antagonists, and dexamethasone are frequently used in obstetrics to prevent postoperative nausea and vomiting (PONV). However, the superiority of any drug class is yet to be established. This network meta-analysis aimed to compare the efficacy of these antiemetics for PONV prophylaxis in women receiving neuraxial morphine for Caesarean delivery.
View Article and Find Full Text PDFMedicina (Kaunas)
February 2024
Department of Anaesthesiology, Teaching Hospital of the University Cologne, Hospital Cologne Holweide, University of Witten-Herdecke, Neufelder Str. 32, 51067 Cologne, Germany.
Nowadays, obstetrical anesthesia-related mortality is a very rare complication in industrialized countries. The recommended choice of intrathecal opioid for spinal anesthesia in the context of a multimodal peripartum pain management concept is discussed in this narrative review. Nowadays, there is a consensus that a perioperative multimodal pain concept should be used for caesarean delivery.
View Article and Find Full Text PDFNeuromodulation
October 2024
Department of Anesthesiology, University of California San Diego, San Diego, CA, USA. Electronic address:
Objectives: Intrathecal opioids delivered by implanted pumps are used to treat malignant or nonmalignant chronic pain. In this study, we 1) review a case in which intrathecal infusions of sufentanil along with other adjuvants were used and after an extended period led to an intrathecal mass and 2) compared and contrasted the potential mechanisms for these phenomena.
Materials And Methods: A woman aged 66 years with a history of scoliosis and multiple spine surgeries was treated with an implantable drug delivery system for treating persistent pain after laminectomy.
Front Med (Lausanne)
January 2024
Department of Anesthesiology, General Hospital of Ningxia Medical University, Yinchuan, China.
Purpose: To determine the 90 percent effective dose (ED90) of intrathecal sufentanil combined with ropivacaine 2.5 mg for labor analgesia and observe its safety for parturients and neonates.
Methods: We conducted a prospective, double-blind, biased coin up-and-down study.
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