The dose-response of intrathecal sufentanil added to bupivacaine for labor analgesia

Cynthia A. Wong*, Barbara M. Scavone, Mariann Loffredi, Warren Y. Wang, Alan M. Peaceman, Jeanne N. Ganchiff

*Corresponding author for this work

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: Regional analgesia for labor often is initiated with an intrathecal injection of a local anesthetic and opioid. The purpose of this prospective, randomized, blinded study was to determine the optimal dose of intrathecal sufentanil when combined with 2.5 mg bupivacaine for labor analgesia. Methods: One hundred seventy parous parturients with cervical dilation between 3-5 cm were randomized to receive intrathecal 0 (control), 2.5, 5.0, 7.5, or 10.0 μg sufentanil combined with 2.5 mg bupivacaine, followed by a lidocaine epidural test dose, for initiation of analgesia (34 patients in each group). Visual analog scores and the presence of nausea, vomiting, and pruritus were determined every 15 min until the patient requested additional analgesia. Fetal heart rate tracings were compared between groups. Results: Groups were similar for age, height, weight, oxytocin dose, duration of labor, and baseline visual analog scores. Duration of action was significantly shorter for control patients (39 ± 25 min [mean ± SD]) compared with those administered sufentanil, all doses (93 ± 32, 93 ± 47, 94 ± 33, 97 ± 39 min), but was not different among groups administered 2.5, 5.0, 7.5, or 10.0 μg sufentanil. More patients who received 10 μg sufentanil reported nausea and vomiting than did control patients. The severity of pruritus increased with administration of 7.5 and 10.0 μg sufentanil. There was no difference in fetal heart rate changes among groups. Conclusions: Intrathecal bupivacaine (2.5 mg) without sufentanil did not provide satisfactory analgesia for parous patients. However, bupivacaine combined with 2.5 μg sufentanil provided analgesia comparable to higher doses, with a lower incidence of nausea and vomiting and less severe pruritus.

Original languageEnglish (US)
Pages (from-to)1553-1558
Number of pages6
JournalAnesthesiology
Volume92
Issue number6
DOIs
StatePublished - Jan 1 2000

Fingerprint

Sufentanil
Bupivacaine
Analgesia
Pruritus
Nausea
Vomiting
Fetal Heart Rate
Spinal Injections
Oxytocin
Lidocaine
Local Anesthetics
Opioid Analgesics
Dilatation
Parturition
Weights and Measures
Incidence

Keywords

  • Intrathecal analgesia
  • Intrathecal opioids
  • Obstetric anesthesia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Wong, Cynthia A. ; Scavone, Barbara M. ; Loffredi, Mariann ; Wang, Warren Y. ; Peaceman, Alan M. ; Ganchiff, Jeanne N. / The dose-response of intrathecal sufentanil added to bupivacaine for labor analgesia. In: Anesthesiology. 2000 ; Vol. 92, No. 6. pp. 1553-1558.
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abstract = "Background: Regional analgesia for labor often is initiated with an intrathecal injection of a local anesthetic and opioid. The purpose of this prospective, randomized, blinded study was to determine the optimal dose of intrathecal sufentanil when combined with 2.5 mg bupivacaine for labor analgesia. Methods: One hundred seventy parous parturients with cervical dilation between 3-5 cm were randomized to receive intrathecal 0 (control), 2.5, 5.0, 7.5, or 10.0 μg sufentanil combined with 2.5 mg bupivacaine, followed by a lidocaine epidural test dose, for initiation of analgesia (34 patients in each group). Visual analog scores and the presence of nausea, vomiting, and pruritus were determined every 15 min until the patient requested additional analgesia. Fetal heart rate tracings were compared between groups. Results: Groups were similar for age, height, weight, oxytocin dose, duration of labor, and baseline visual analog scores. Duration of action was significantly shorter for control patients (39 ± 25 min [mean ± SD]) compared with those administered sufentanil, all doses (93 ± 32, 93 ± 47, 94 ± 33, 97 ± 39 min), but was not different among groups administered 2.5, 5.0, 7.5, or 10.0 μg sufentanil. More patients who received 10 μg sufentanil reported nausea and vomiting than did control patients. The severity of pruritus increased with administration of 7.5 and 10.0 μg sufentanil. There was no difference in fetal heart rate changes among groups. Conclusions: Intrathecal bupivacaine (2.5 mg) without sufentanil did not provide satisfactory analgesia for parous patients. However, bupivacaine combined with 2.5 μg sufentanil provided analgesia comparable to higher doses, with a lower incidence of nausea and vomiting and less severe pruritus.",
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The dose-response of intrathecal sufentanil added to bupivacaine for labor analgesia. / Wong, Cynthia A.; Scavone, Barbara M.; Loffredi, Mariann; Wang, Warren Y.; Peaceman, Alan M.; Ganchiff, Jeanne N.

In: Anesthesiology, Vol. 92, No. 6, 01.01.2000, p. 1553-1558.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The dose-response of intrathecal sufentanil added to bupivacaine for labor analgesia

AU - Wong, Cynthia A.

AU - Scavone, Barbara M.

AU - Loffredi, Mariann

AU - Wang, Warren Y.

AU - Peaceman, Alan M.

AU - Ganchiff, Jeanne N.

PY - 2000/1/1

Y1 - 2000/1/1

N2 - Background: Regional analgesia for labor often is initiated with an intrathecal injection of a local anesthetic and opioid. The purpose of this prospective, randomized, blinded study was to determine the optimal dose of intrathecal sufentanil when combined with 2.5 mg bupivacaine for labor analgesia. Methods: One hundred seventy parous parturients with cervical dilation between 3-5 cm were randomized to receive intrathecal 0 (control), 2.5, 5.0, 7.5, or 10.0 μg sufentanil combined with 2.5 mg bupivacaine, followed by a lidocaine epidural test dose, for initiation of analgesia (34 patients in each group). Visual analog scores and the presence of nausea, vomiting, and pruritus were determined every 15 min until the patient requested additional analgesia. Fetal heart rate tracings were compared between groups. Results: Groups were similar for age, height, weight, oxytocin dose, duration of labor, and baseline visual analog scores. Duration of action was significantly shorter for control patients (39 ± 25 min [mean ± SD]) compared with those administered sufentanil, all doses (93 ± 32, 93 ± 47, 94 ± 33, 97 ± 39 min), but was not different among groups administered 2.5, 5.0, 7.5, or 10.0 μg sufentanil. More patients who received 10 μg sufentanil reported nausea and vomiting than did control patients. The severity of pruritus increased with administration of 7.5 and 10.0 μg sufentanil. There was no difference in fetal heart rate changes among groups. Conclusions: Intrathecal bupivacaine (2.5 mg) without sufentanil did not provide satisfactory analgesia for parous patients. However, bupivacaine combined with 2.5 μg sufentanil provided analgesia comparable to higher doses, with a lower incidence of nausea and vomiting and less severe pruritus.

AB - Background: Regional analgesia for labor often is initiated with an intrathecal injection of a local anesthetic and opioid. The purpose of this prospective, randomized, blinded study was to determine the optimal dose of intrathecal sufentanil when combined with 2.5 mg bupivacaine for labor analgesia. Methods: One hundred seventy parous parturients with cervical dilation between 3-5 cm were randomized to receive intrathecal 0 (control), 2.5, 5.0, 7.5, or 10.0 μg sufentanil combined with 2.5 mg bupivacaine, followed by a lidocaine epidural test dose, for initiation of analgesia (34 patients in each group). Visual analog scores and the presence of nausea, vomiting, and pruritus were determined every 15 min until the patient requested additional analgesia. Fetal heart rate tracings were compared between groups. Results: Groups were similar for age, height, weight, oxytocin dose, duration of labor, and baseline visual analog scores. Duration of action was significantly shorter for control patients (39 ± 25 min [mean ± SD]) compared with those administered sufentanil, all doses (93 ± 32, 93 ± 47, 94 ± 33, 97 ± 39 min), but was not different among groups administered 2.5, 5.0, 7.5, or 10.0 μg sufentanil. More patients who received 10 μg sufentanil reported nausea and vomiting than did control patients. The severity of pruritus increased with administration of 7.5 and 10.0 μg sufentanil. There was no difference in fetal heart rate changes among groups. Conclusions: Intrathecal bupivacaine (2.5 mg) without sufentanil did not provide satisfactory analgesia for parous patients. However, bupivacaine combined with 2.5 μg sufentanil provided analgesia comparable to higher doses, with a lower incidence of nausea and vomiting and less severe pruritus.

KW - Intrathecal analgesia

KW - Intrathecal opioids

KW - Obstetric anesthesia

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