Maternal Analgesia and Neonatal Effects of Epidural Sufentanil for Cesarean Section

Capogna, G.; Celleno, D.; Tomassetti, Marco; Datta, Sujata

doi:10.1097/00132582-199007000-00052

Cited by 3 publications

(4 citation statements)

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“…Definitions include pain during surgery; requirement for additional intra‐operative analgesia; the inability to achieve a desired sensory level of anaesthesia; poor maternal satisfaction; and requirement for conversion to an alternative anaesthetic technique (including conversion to general anaesthesia). The percentage of neuraxial anaesthesia cases for caesarean section in which conversion to general anaesthesia is specifically required for neuraxial anaesthesia inadequacy remains unclear [9, 10].…”

Section: Introductionmentioning

confidence: 99%

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Inadequate neuraxial anaesthesia in patients undergoing elective caesarean section: a systematic review

et al. 2022

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Neuraxial anaesthesia is widely utilised for elective caesarean section, but the prevalence of inadequate intraoperative anaesthesia is unclear. We aimed to determine the prevalence of inadequate neuraxial anaesthesia for elective caesarean section; prevalence of conversion from neuraxial anaesthesia to general anaesthesia following inadequate neuraxial anaesthesia; and the effect of mode of anaesthesia. We searched studies reporting inadequate neuraxial anaesthesia that used ≥ ED95 doses (effective dose in 95% of the population) of neuraxial local anaesthetic agents. Our primary outcome was the prevalence of inadequate neuraxial anaesthesia, defined as the need to convert to general anaesthesia; the need to repeat or abandon a planned primary neuraxial technique following incision; unplanned administration of intra-operative analgesia (excluding sedatives); or unplanned epidural drug supplementation. Fifty-four randomised controlled trials were included (3497 patients). The overall prevalence of requirement for supplemental analgesia or anaesthesia was 14.6% (95%CI 13.3-15.9%); 510 out of 3497 patients. The prevalence of general anaesthesia conversion was 2 out of 3497 patients (0.06% (95%CI 0.0-0.2%)). Spinal/combined spinal-epidural anaesthesia was associated with a lower overall prevalence of inadequate neuraxial anaesthesia than epidural anaesthesia (10.2% (95%CI 9.0-11.4%), 278 out of 2732 patients vs. 30.3% (95%CI 26.5-34.5%), 232 out of 765 patients). Further studies are needed to identify risk factors, optimise detection and management strategies and to determine long-term effects of inadequate neuraxial anaesthesia.

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Section: Introductionmentioning

confidence: 99%

“…The percentage of neuraxial anaesthesia cases for caesarean section in which conversion to general anaesthesia is specifically required for neuraxial anaesthesia inadequacy remains unclear [9,10].…”

Section: Introductionmentioning

confidence: 99%

Inadequate neuraxial anaesthesia in patients undergoing elective caesarean section: a systematic review

et al. 2022

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“…Capogna et al studied 45 healthy parous women undergoing repeat elective Caesarean section [9]. The patients received either 2% lignocaine with adrenaline (1 : 200 000) or lignocaine with either 50 or 80 pg sufentanil.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the addition of three different doses of sufentanil to 0.125% bupivacaine given epidurally during labour

1994

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In a double-blind, randomheed, prospective study 150 women in labour received intermittent epidural injections of 10 mlO.l25% bupivacaine with adrenaline (1 :800000) with 5, 7.5 or 10 pg of sufentanil added. The onset, duration, and quality of analgesia were compared. Motor block, type of delivery and neonatal Apgar scores were noted. The onset, duration, and quality of analgesia were generally similar in the three groups, except following the second injection when the quality of analgesia was signijcantly superior in the sufentanil 7.5 and 10 pg groups. Motor blockade and type of delivery did not difer between the groups and there were no diferences in neonatal Apgar scores. No patient required more than three injections. We conclude that 7.5 pg sufentanil is the optimal dose to add to intermittent epidural injections of 10 mi 0.125% bupivacaine with adrenaline ( 1 : 800 000) for pain relief in labour.

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“…The possibility of neonatal depression from opioids injected close to delivery has been investigated and did occur with alfentanil ll and with the higher dose of sufentanil 80 mcg 30 but with fentanyl 1.0 mcglkg 29 ,49 and sufentanil 50 mcg 30 no neonatal effects were observed. Apgar scores, neurologic and adaptive capacity scores and early neonatal neurobehavioural scale assessment did not differ significantly from controls.…”

Section: (I) Neonatal Effectsmentioning

confidence: 99%

Epidural Opioids in Obstetrics —003 A003 Review

Westmore

1990

Anaesth Intensive Care

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Epidural opioids have been used in obstetrics since 1980. Various opioids are reviewed in relation to their pharmacology, their efficacy in labour, during caesarean section and for postoperative analgesia, their side-effects and safety. In this patient population it appears safe to administer epidural opioids on the general ward provided that strict monitoring standards are maintained. Practical considerations of nursing management are discussed.

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Maternal Analgesia and Neonatal Effects of Epidural Sufentanil for Cesarean Section

Cited by 3 publications

References 0 publications

Inadequate neuraxial anaesthesia in patients undergoing elective caesarean section: a systematic review

Inadequate neuraxial anaesthesia in patients undergoing elective caesarean section: a systematic review

Comparison of the addition of three different doses of sufentanil to 0.125% bupivacaine given epidurally during labour

Epidural Opioids in Obstetrics —003 A003 Review

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