Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Randomized controlled study

Braga, Angélica de Fátima de Assunção; Braga, Franklin Sarmento da Silva; Hirata, Eunice Sizue; Pereira, Rosa Inês Costa; Frias, José Aristeu Fachini; Antunes, Isadora Fregonese

doi:10.1590/s0102-86502014001800010

Cited by 10 publications

(13 citation statements)

References 25 publications

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“…Motiani et al ( 26 ) and Dourado et al ( 31 ) mentioned higher frequency of itching in sufentanil group than other groups. Although Braga et al ( 21 ) mentioned no significant difference in the incidence of itching between the 2 groups as well, itching was much more noted in sufentanil group, and this result was inconsistent with ours. This difference in the results might be noted as a result of lower dosage of administered sufentanil in our study (2.5 mcg) compared to others (5 - 7.5 mcg).…”

Section: Discussioncontrasting

confidence: 80%

“…Our study revealed that the use of fentanyl (25 mcg) and sufentanil (2.5 mcg) in combination with intrathecal bupivacaine was associated with more appropriate analgesia (312.5 minutes and 314 minutes, respectively) compared to 116 minutes by placebo during and after surgery. In a study by Braga et al ( 21 ), duration of analgesia in the fentanyl group was 177 minutes and it was 210 minutes in sufentanil group, and this difference might be noted as a result of lower dose of administered bupivacaine (10 mg). However, Saraswat et al ( 24 ) mentioned 322 and 409 minutes of analgesia by fentanyl and sufentanil groups, respectively.…”

Section: Discussionmentioning

confidence: 92%

“…Among opioids, lipophilic drugs (fentanyl, sufentanil) have appropriate pharmacological effects for spinal anesthesia. These drugs have rapid onset, moderate duration of action, and low affinity to expand to the fourth vertebrae, and thus they are associated with a decreased risk of respiratory depression ( 21 ). Regardless of the wide use of opioids (6.25 - 50 mcg of fentanyl and 2.5 - 7.5 mcg of sufentanil) in combination with hyperbaric bupivacaine for Cesarean section, there is no consensus on the optimum dosage of fentanyl and sufentanil ( 3 , 5 - 7 , 22 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

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Comparing the Effect of Adding Fentanyl, Sufentanil, and Placebo with Intrathecal Bupivacaine on Duration of Analgesia and Complications of Spinal Anesthesia in Patients Undergoing Cesarean Section

et al. 2017

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BackgroundSpinal anesthesia is the method of choice for most elective and emergency Cesarean sections. To increase the duration of anesthesia and improve the quality of analgesia during and after surgery, intrathecal opioids, as adjuvant drugs, are used in combination with local anesthetics.MethodsThis was a double-blind clinical trial performed on 99 patients. Women were divided into 3 groups of fentanyl, sufentanil, and placebo. For fentanyl group, 12.5 mg of bupivacaine and 25 micrograms of fentanyl; for sufentanil group, 12.5 mg of bupivacaine and 2.5 micrograms of sufentanil; and for placebo group, 12.5 mg of bupivacaine and a half mL of normal saline were injected in subarachnoid space. The sensory and motor block, hemodynamic status (mean blood pressure and heart rate), and probable complications were assessed.ResultsThere was no significant difference between the groups in demographic characteristics. Durations of analgesia were, respectively, 314 ± 42.95, 312.5 ± 34.44, and 116.1 ± 42.24 minutes in the fentanyl, sufentanil, and placebo groups (P = 0.0001). Duration of sensory and motor block was higher in fentanyl and sufentanil groups compared with the placebo group. The highest duration of sensory and motor block was noted in sufentanil group (P = 0.0001). No significant difference was found between the groups in the hemodynamic parameters (P > 0.05). The frequency of itching in the fentanyl group was higher than sufentanil and placebo groups (P = 0.003). Also, shivering was higher in the placebo group compared with other groups (P = 0.036).ConclusionsAccording to the results, adding 25 microgram fentanyl or 2.5 microgram sufentanil to intrathecal bupivacaine increased the duration of analgesia and provided hemodynamic stability with no major complication. As administering intrathecal fentanyl had a similar duration of analgesia like sufentanil with faster return of motor block and ambulation, it seems that it is a preferred additive for Cesarean section surgery.

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Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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Comparing the Effect of Adding Fentanyl, Sufentanil, and Placebo with Intrathecal Bupivacaine on Duration of Analgesia and Complications of Spinal Anesthesia in Patients Undergoing Cesarean Section

et al. 2017

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“…Lipophilic opioids are used as adjuvants in central blockades. Fentanyl at a dose of 25 µg and sufentanil at a dose of 5 µg in combination with hyperbaric bupivacaine used for spinal anesthesia of caesarean section are characterized by comparable effectiveness, they are safe for the mother and the fetus, while the analgesic effect of sufentanil lasts longer [8]. Sufentanil has no negative effects on the fetus due to its binding to alpha1-glycoprotein at doses below 30 µg.…”

Section: Anaesthetic Drugsmentioning

confidence: 99%

Anaesthesia of pregnant women

Jastrzębska-Stojko

Sadłocha

2021

Ginekol Pol

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“…This is consistent with the results of previous studies. 16 – 17 …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Randomized controlled study

Cited by 10 publications

References 25 publications

Comparing the Effect of Adding Fentanyl, Sufentanil, and Placebo with Intrathecal Bupivacaine on Duration of Analgesia and Complications of Spinal Anesthesia in Patients Undergoing Cesarean Section

Comparing the Effect of Adding Fentanyl, Sufentanil, and Placebo with Intrathecal Bupivacaine on Duration of Analgesia and Complications of Spinal Anesthesia in Patients Undergoing Cesarean Section

Anaesthesia of pregnant women

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

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