Addition of low-dose sufentanil to ropivacaine for reducing shivering and visceral traction pain during cesarean section

Abstract

Objective To investigate the efficacy of low-dose sufentanil for preventing shivering and visceral traction pain during cesarean section under spinal anesthesia. Methods This was a prospective, randomized, controlled study. A total of 112 full-term parturients who underwent elective caesarean delivery were randomly divided into two groups. Group R received 0.75% isobaric ropivacaine intrathecally and group RS received 0.75% isobaric ropivacaine plus 5 µg sufentanil intrathecally. Results There were no significant differences in the maximum sensory block time, motor block time, duration of the surgery, and heart rate, mean arterial pressure, and blood oxygen saturation before and 1, 5, and 10 minutes after spinal anesthesia, and at the end of the surgery between the two groups. Shivering was significantly more common in group R (n = 30) than in group RS (n = 8). The incidence of visceral traction pain in group R (46.43%) was significantly higher than that in group RS (14.29%). There was no significant difference in the newborns’ Apgar scores between the groups. Conclusion Adding low-dose sufentanil to ropivacaine can significantly reduce the incidence of shivering and visceral traction pain after spinal anesthesia.

Epidural Infusion of Dexmedetomidine Improves the Experience of Primiparas Undergoing Cesarean Section with Epidural Anesthesia: A Randomized Double‑Blinded Controlled Study

“…Previous studies have investigated the effect of applying a low dose of opioids (such as fentanyl) added to local anesthetics for neuraxial anesthesia, to enhance the neural block (23,24). Although anesthetic effect was improved, neuraxial opioids can also lead to serious side effects(7, 8), and parturients still didn't bene t from appropriate sedation.…”

Risk factors associated with intraoperative shivering during caesarean section: a prospective nested case-control study

“…The initial shivering in the operating room was strongly associated with the labor analgesia, suggesting that the analgesics used during cesarean sections might induce shivering. Previous studies have reported that ropivacaine and lidocaine could increase shivering during cesarean sections [ 27 , 28 ]. Anesthesia may cause vasodilation, and cold disinfectant further promotes chills.…”

Cytochrome P4503A4 gene polymorphisms guide safe sufentanil analgesic doses in pregnant Chinese mothers: a multicenter, randomized, prospective study

“…Sufentanil is widely used as an intravenous, subarachnoid, epidural anesthetic, and also adjuncts in epidural labor analgesia, with rapid onset, stronger actions, and high lipid solubility [5,6]. Studies have shown that when compared with ropivacaine alone, sufentanil plus ropivacaine induces better pain relief, reduces cesarean section incidence and adverse reactions during epidural labor analgesia [7,8]. However, during analgesia administration, excessive quantities may prolong labor and even affect maternal health (hypotension) and also newborns (heart rate abnormalities) [1].…”