Revista Brasileira de Anestesiologia
Print version ISSN 0034-7094
STOCCHE, Renato Mestriner; GARCIA, Luiz Vicente and KLAMT, Jyrson Guilherme. Effects of analgesic intrathecal sufentanil and 0.25% epidural bupivacaine on oxytocin and cortisol plasma concentration in labor patients. Rev. Bras. Anestesiol. [online]. 2001, vol.51, n.4, pp. 285-297. ISSN 0034-7094. http://dx.doi.org/10.1590/S0034-70942001000400003.
BACKGROUND AND OBJECTIVES: Intrathecal sufentanil provides analgesia comparable to epidural local anesthetics for labor pain. Both techniques decrease some parameters of neuroendocrine response to labor pain and both may mitigate reflex oxytocin release in animals. This study aimed to compare the effect of both techniques on cortisol (CPC) and oxytocin (OPC) plasma concentrations in labor patients. METHODS: Participated in this randomized covered study 30 healthy parturients in spontaneous labor with 4-7 cm cervical dilatation. Group S patients received intrathecal sufentanil (10 mg) and group B received epidural 0.25% bupivacaine. Analgesia was assessed by a visual analogue scale and blood oxytocin and cortisol samples were collected before, 30 and 60 minutes after drug administration. Plasma cortisol and oxytocin concentrations were determined by radioimmunoassay. RESULTS: Group S analgesia was more intense at 30 minutes. OPC and CPC before analgesia were similar for both groups. Group S showed a significant decrease in OPC at 60 minutes and in CPC at 30 and 60 minutes (p<0.05), while for Group B such values remained stable throughout the study. CONCLUSIONS: In the conditions of this study, epidural bupivacaine analgesia was associated to stable plasma cortisol and oxytocin concentrations. Conversely, intrathecal sufentanil promoted a more intense analgesia and decreased OPC and CPC.
Keywords : ANALGESIA [labor]; ANALGESICS, Opioids [sufentanil]; ANESTHETIC TECHNIQUES, Regional [epidural]; HORMONES [cortisol, oxytocin].