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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
YAMAGUCHI, Eduardo Tsuyoshi et al. Spinal sufentanil associated to hyperbaric bupivacaine: Is it possible to decrease opioid dose?. Rev. Bras. Anestesiol. [online]. 2004, vol.54, n.2, pp. 145-152. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942004000200002.
BACKGROUND AND OBJECTIVES: The association of isobaric bupivacaine to lower spinal sufentanil dose provides satisfactory analgesia and lower incidence of side effects. This study aimed at evaluating quality of analgesia and incidence of side effects of decreased spinal sufentanil doses associated to hyperbaric bupivacaine for labor analgesia. METHODS: Participated in this study 69 healthy term pregnant patients in active labor. Patients were randomly allocated in three groups receiving spinal combination of 2.5 mg hyperbaric bupivacaine and 1 mL saline solution (Control Group); 2.5 mg hyperbaric bupivacaine and 2.5 µg sufentanil (S2.5 Group) or 2.5 mg hyperbaric bupivacaine and 5 µg sufentanil (S5 Group). Pain, using a visual analogue scale (VAS), and side effects were evaluated at 5-minute intervals for the first 15 minutes and then at 15-minute interval until delivery. Study would end with delivery or when patient requested rescue analgesia (VAS > 3 cm). RESULTS: Groups S2.5 and S5 presented longer analgesia duration (67.2 ± 38.6 and 78.9 ± 38.7 minutes, respectively) and a larger number of patients with effective analgesia (100% and 95.6%, respectively) as compared to Control group where mean analgesia duration was 35.9 ± 21.6 minutes (p < 0.05) with 69.6% of patients with effective analgesia (p < 0.05). CONCLUSIONS: The association of sufentanil to hyperbaric bupivacaine improves quality and prolongs analgesia duration. When associated to 2.5 mg hyperbaric bupivacaine, there is no benefit in administering more than 2.5 µg of sufentanil for labor pain relief.
Keywords : ANALGESIA [labor]; ANALGESICS [Opioids]; ANALGESICS [sufentanil]; ANESTHETICS [Local]; ANESTHETICS [bupivacaine]; ANESTHETIC TECHNIQUES [Regional]; ANESTHETIC TECHNIQUES [combined]; ANESTHETIC TECHNIQUES [epidural]; ANESTHETIC TECHNIQUES [spinal block].