This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (16) Citing Articles via Google Scholar Google Scholar Articles by Sia, A. T. H. Articles by Chiu, J. W. Search for Related Content PubMed PubMed Citation Articles by Sia, A. T. H. Articles by Chiu, J. W.

---

OBSTETRIC ANESTHESIA

Combination of Intrathecal Sufentanil 10 µg Plus Bupivacaine 2.5 mg for Labor Analgesia: Is Half the Dose Enough?

Department of Anesthesia, KK Women and Children's Hospital, Singapore

Address correspondence and reprint requests to Alex T. H. Sia, Department of Anaesthesia, KK Women and Children's Hospital, 100 Bukit Timah Rd., Singapore 229 899.

This controlled, double-blinded, prospective trial of 42 parturients in early labor was conducted to determine whether halving the total amount of intrathecal (IT) sufentanil and bupivacaine reduced the incidence of systemic hypotension while providing adequate analgesia with minimal lower limb motor block. Combined spinal-epidural analgesia (CSE) was instituted; Group A (n = 21) received a total of 10 µg of sulfentanil plus 2.5 mg of bupivacaine, whereas Group B (n = 21) received half that dose. Compared with Group B, Group A had a higher incidence of hypotension (nine parturients in Group A, two in Group B; P < 0.05), a greater degree of motor block (P < 0.05), and a higher incidence of sedation (nine parturients in Group A were sedated, one in Group B; P < 0.01). Group B had higher pain scores for the first 5 min (P < 0.05) and a lower level of sensory blockade (median of T7 in Group B compared with T4 in Group A; P < 0.01). We conclude that halving the total amount of IT 10 µg of sufentanil plus 2.5 mg of bupivacaine is a suitable option for CSE in labor because it reduces the incidence of some side effects, such as hypotension and maternal sedation, without compromising overall high maternal satisfaction.

Implications: We showed that adequate labor pain relief could be provided by halving the recommended dose of 10 µg of intrathecal sufentanil plus 2.5 mg of bupivacaine. The larger dose, however, produced faster pain relief, which lasted longer than the reduced dose. The mother and baby were not adversely affected with either dose.

This article has been cited by other articles:

				S. Y. Kim, J. E. Cho, J. Y. Hong, B. N. Koo, J. M. Kim, and H. K. Kil Comparison of intrathecal fentanyl and sufentanil in low-dose dilute bupivacaine spinal anaesthesia for transurethral prostatectomy Br. J. Anaesth., November 1, 2009; 103(5): 750 - 754. [Abstract] [Full Text] [PDF]

				B. Carvalho Respiratory Depression After Neuraxial Opioids in the Obstetric Setting Anesth. Analg., September 1, 2008; 107(3): 956 - 961. [Abstract] [Full Text] [PDF]

				W. H. L. Teoh and A. T. H. Sia Hyperbaric Bupivacaine 2.5 mg Prolongs Analgesia Compared with Plain Bupivacaine When Added to Intrathecal Fentanyl 25 {micro}g in Advanced Labor Anesth. Analg., September 1, 2003; 97(3): 873 - 877. [Abstract] [Full Text] [PDF]

				D. J. Birnbach, J. Matut, D. J. Stein, J. Campagnuolo, C. Drimbarean, A. Grunebaum, M. M. Kuroda, and D. M. Thys The Effect of Intrathecal Analgesia on the Success of External Cephalic Version Anesth. Analg., August 1, 2001; 93(2): 410 - 413. [Abstract] [Full Text] [PDF]

				D. J. Birnbach Obstetric Anesthesiology in the New Millennium Anesth. Analg., May 1, 2000; 90(5): 1241 - 1243. [Full Text] [PDF]

				J. A. Crowhurst and D. J. Birnbach Small-Dose Neuraxial Block: Heading Toward the New Millennium Anesth. Analg., February 1, 2000; 90(2): 241 - 241. [Full Text] [PDF]