Does epidural sufentanil provide effective analgesia per‐and postoperatively for abdominal aortic surgery?

Abstract

To assess the efficacy of epidural sufentanil in providing per- and postoperative analgesia, 40 patients undergoing elective abdominal aortic surgery received either 50 mu g sufentanil in 10 ml normal saline solution (n = 20, ES group) or 10 ml normal saline (n = 20, control group) via a thoracic epidural catheter. The study solution was given (double-blind and at random) after the patients had been anaesthetized with i.v. midazolam, sufentanil and vecuronium. Anaesthesia was maintained with 60% nitrous oxide in oxygen and halothane at a 1% inspiratory concentration. When patients showed signs of inadequate analgesia, supplementary doses of 25 mu g sufentanil were given i.v. The number of patients requiring additional i.v. sufentanil differed significantly between the two groups: 5 out of 20 patients in the ES group vs 13 out of 20 patients in the control group required additional sufentanil (P<0.05). The mean dose administered i.v. did not differ significantly between the two groups: 105 +/- 109.5 mu g vs 138.5 +/- 126.9 mu g (mean +/- SD) in 5 and 13 patients, respectively. No cardiovascular changes were observed after the epidural bolus dose. Postoperative analgesia, consisting of a continuous epidural infusion of 50 mu g sufentanil in 50 ml bupivacaine 0.125% at a rate of 6-10 ml/h after a bolus dose of 10 ml of this solution, was adequate in the majority of patients, as determined by VAS-scores assessed during the epidural treatment (4.3 +/- 1.5 days).

Evaluation of pain scoring and free cortisol levels of postoperative analgesic methods in cardiac surgery: A new perspective

“…[6] Fentanyl, with its rapid onset, has for long been widely used in cardiac anesthesia and analgesia, since it does not cause cardiovascular depression. [7] However, there is a limited number of studies comparing these two analgesic substances in terms of preventing the effects of postoperative pain.…”

Low-dose sufentanil dœs not potentiate intra-thecal morphine for perioperative analgesia after major colorectal surgery

“…1 Its analgesic efficacy at low-doses (2.5-10 µg) combined to a local anesthetic is well documented in obstetrics where it improves analgesia during labour and intraoperative Cesarean delivery. [9][10][11][12][13] In abdominal surgery, sufentanil is usually administered epidurally or intravenously 14,15 and the clinical experience in non-vascular major abdominal surgery with ITS is still limited. A recent study in major abdominal surgery showed that a large dose of ITS (150 µg) was able to blunt the intraoperative stress response and produced effective analgesia, but was associated with prolonged mechanical ventilation.…”