Investigation of the Minimum Local Analgesic Concentration of Epidural Sufentanil Combined With Ropivacaine for Labor Analgesia

Cai, Shengchang; Zheng, Jing; Meng, Qiong; Chai, Jing; Ma, Rui; Wang, Yilong; Zhang, Wangping; Yang, Zeyong

doi:10.1016/j.clinthera.2019.10.011

Cited by 9 publications

(7 citation statements)

References 30 publications

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“…Cai et al determined the EC50s of sufentanil and ropivacaine separately. 20 The EC50 of epidural ropivacaine combined with 0.3µg/mL sufentanil was 0.09687% (95% CI, 0.08944–0.1043%), while that for epidural sufentanil when co-administered with 0.1% ropivacaine was 18.76 µg (95% CI 13.5–24.48). The EC50 calculated in our study (0.085%) was lower because sufentanil was administered at relatively higher concentrations.…”

Section: Discussionmentioning

confidence: 96%

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Adjuvant Sufentanil Decreased the EC50 of Epidural Ropivacaine for Labor Analgesia in Healthy Term Pregnancy

Xiang

Lei

2021

DDDT

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Objective: The optimal concentration of ropivacaine as epidural labor analgesia combined with sufentanil has not been established. This study aimed to determine the median effective concentration (EC50) of epidural ropivacaine for labor analgesia in healthy term pregnancy when co-administered with sufentanil as an adjuvant or alone. Patients and Methods: Sixty healthy parturients scheduled for epidural labor analgesia were enrolled in the study. They were divided into a saline group (Group C) and an epidural sufentanil (0.5 µg/mL) group (Group S). The initial concentration of ropivacaine was set at 0.125%, which was then varied by 0.01% using the up-and-down sequential allocation method. The hemodynamics were continuously monitored during delivery. A visual analog scale was used to evaluate the degree of pain. The Ramsay sedation score, duration of the labor stages, the onset of epidural analgesia, and adverse effects were recorded. Neonatal outcomes were evaluated using the Apgar scores and umbilical artery blood gas analysis. Results: The EC50 of ropivacaine was 0.085% (95% CI, 0.079-0.090%) in Group S and 0.109% (95% CI, 0.105-0.112%) in Group C. The EC95 of ropivacaine was 0.096% (95% CI, 0.090-0.118%) in Group S, and 0.116% (95% CI, 0.113-0.127%) in Group C. The difference between the groups was statistically significant (p < 0.001). The stable hemodynamics, satisfactory analgesia, and good neonatal outcomes were comparable in both groups (P > 0.05). Conclusion:The EC50 of ropivacaine was reduced by 22% when co-administered with sufentanil for epidural labor analgesia in primipara. (www.chictr.org.cn; registration number: ChiCTR2000039547).

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Section: Discussionmentioning

confidence: 96%

“…Cai et al determined the EC50s of sufentanil and ropivacaine separately. 20 The EC50 of epidural ropivacaine Figure 2 Stepwise dose adjustment of ropivacaine for epidural labor analgesia using up-and-down method. "•" indicate an effective dose, and "▲" indicate an ineffective dose.…”

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confidence: 99%

Adjuvant Sufentanil Decreased the EC50 of Epidural Ropivacaine for Labor Analgesia in Healthy Term Pregnancy

Xiang

Lei

2021

DDDT

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“…The differences in research methods, drug types, and drug doses are the possible reasons for the differences in the research results. Other scholars believe that the duration of epidural labor analgesia has a circadian rhythm, and the action time of the same dose of drugs in the daytime is longer than that at night [ 32 ]. It also suggests that we should consider the effect of circadian rhythm on analgesia time, so as to make the research groups more comparable.…”

Section: Discussionmentioning

confidence: 99%

Analgesic Effects, Birth Process, and Prognosis of Pregnant Women in Normal Labor by Epidural Analgesia Using Sufentanil in Combination with Ropivacaine: A Retrospective Cohort Study

Mao

Zhang

Zhu

2022

Computational Intelligence and Neuroscience

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Objective. The objective is to evaluate the analgesic, labor, and prognostic effects of patient-controlled epidural analgesia (PCEA) versus sufentanil in conjunction with ropivacaine in normal labor. Methods. Sixty pregnant women who had a normal delivery at our hospital between February 2019 and April 2021 were included. Pregnant women were arbitrarily assigned to a control group and a research group. Pregnant women in the control group received lidocaine analgesia and PCEA with sufentanil combined with ropivacaine in the research group. Satisfaction with care, fetal umbilical artery blood flow, VAS score, labor and bleeding, neonatal Apgar score and incidence of adverse events were analyzed. Results. First, we made a comparison of satisfactory performance of nursing care. The satisfaction rate of the research group was 100.00%, compared to 83.33% for the control group. Nursing satisfaction was higher in the research group, and the difference was statistically significant ( P < 0.05 ). Following analgesia, PI, RI, and S/D values of umbilical artery blood flow were lower in the research group than those in the control group, but the difference was not statistically significant ( P > 0.05 ). The VAS scores at 10 min, 20 min, and 30 min were found to be lower in the research group than in the control group after analgesia, and the difference was statistically significant ( P < 0.05 ). Bleeding was significantly lower in the research group for all stages of labor, and the difference was statistically significant ( P < 0.05 ). Apgar scores at 1 minute, 5 minutes, and 10 minutes postpartum were greater in the research group than in the control group, and the difference was statistically significant ( P < 0.05 ). As a final note, the incidence of pruritus, hypotension, respiratory depression, nausea, and vomiting was found to be lower in the research group than in the control group, and the difference was statistically significant ( P < 0.05 ). Conclusion. PCEA with sufentanil coupled with ropivacaine was used to perform labor analgesia. With significant reduction in maternal pain and assurance of labor, ropivacaine combined with sufentanil epidural labor analgesia did not reduce fetal umbilical artery blood flow without extended labor. It could not affect the labor process or the safety of the fetus, which is safe for the mother and fetus.

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“…Therefore, a test dose with low concentration and volume of local anesthetics, is usually injected to ensure that the cannula is in the epidural space before a larger dose of local anesthetics infused through the catheter [ 4 , 5 ]. Classical test doses include 45 mg lidocaine and 15 μg epinephrine [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Using part of the initial analgesic dose as the epidural test dose did not delay the onset of labor analgesia: a randomized controlled clinical trial

Chen,

et al. 2024

BMC Pregnancy Childbirth

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Background Epidural test dose for labor analgesia is controversial and varies widely in clinical practice. It is currently unclear whether using a portion of the initial dose for analgesia as the test dose delays the onset time of analgesia, compared to the traditional test dose. Methods One hundred and twenty-six parturients who chose epidural analgesia during labor were randomly assigned to two groups. The first dose in group L was 3 ml 1.5% lidocaine, and in the RF group was 10 ml 0.1% ropivacaine combined with 2 μg/ml fentanyl. After 3 min of observation, both groups received 8 ml 0.1% ropivacaine combined with 2 μg/ml fentanyl. The onset time of analgesia, motor and sensory blockade level, numerical pain rating scale, patient satisfaction score, and side effects were recorded. Results The onset time of analgesia in group RF was similar to that in group L (group RF vs group L, 7.0 [5.0–9.0] minutes vs 8.0 [5.0–11.0] minutes, p = 0.197). The incidence of foot numbness (group RF vs group L, 34.9% vs 57.1%, p = 0.020) and foot warming (group RF vs group L, 15.9% vs 47.6%, p < 0.001) in group RF was significantly lower than that in group L. There was no difference between the two groups on other outcomes. Conclusions Compared with 1.5% lidocaine 3 ml, 0.1% ropivacaine 10 ml combined with 2 μg/ml fentanyl as an epidural test dose did not delay the onset of labor analgesia, and the side effects were slightly reduced. Clinical trial registration http://www.chictr.org.cn (ChiCTR2100043071).

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Investigation of the Minimum Local Analgesic Concentration of Epidural Sufentanil Combined With Ropivacaine for Labor Analgesia

Cited by 9 publications

References 30 publications

Adjuvant Sufentanil Decreased the EC50 of Epidural Ropivacaine for Labor Analgesia in Healthy Term Pregnancy

Adjuvant Sufentanil Decreased the EC50 of Epidural Ropivacaine for Labor Analgesia in Healthy Term Pregnancy

Analgesic Effects, Birth Process, and Prognosis of Pregnant Women in Normal Labor by Epidural Analgesia Using Sufentanil in Combination with Ropivacaine: A Retrospective Cohort Study

Using part of the initial analgesic dose as the epidural test dose did not delay the onset of labor analgesia: a randomized controlled clinical trial

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