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Clinical Trial
. 2021 May 18:15:2143-2149.
doi: 10.2147/DDDT.S307478. eCollection 2021.

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

Bo Xiang  1 , Jian Yang  2 , Xiaofeng Lei  1 , Jin Yu  1
Affiliations
Clinical Trial

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

Bo Xiang et al. Drug Des Devel Ther. .

Abstract

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).

Keywords: labor analgesia; median effective concentration; ropivacaine; sufentanil.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of study.
Figure 2
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.
Figure 3
Figure 3
Stepwise dosage adjustment of epidural ropivacaine for labor analgesia combined with sufentanil. “●” indicate an effective dose, and “▲” indicate an ineffective dose.
See this image and copyright information in PMC

References

    1. Juang J, Gabriel RA, Dutton RP, Palanisamy A, Urman RD. Choice of anesthesia for cesarean delivery: an analysis of the national anesthesia clinical outcomes registry. Anesth Analg. 2017;124(6):1914–1917. doi:10.1213/ANE.0000000000001677 - DOI - PubMed
    1. American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 209: obstetric analgesia and anesthesia. Obstet Gynecol. 2019;133(3):e208–e225. doi:10.1097/AOG.0000000000003132 - DOI - PubMed
    1. Mitra S, Arora J, Ahuja V, Takkar N. Combined spinal-epidural for labor analgesia with low-dose bupi- vacaine but without any opioid in the spinal component: can we improve upon the traditional? Acta Anaesthesiol Belg. 2015;66(4):9–15. - PubMed
    1. Nakamura G, Ganem EM, Rugolo LM, Castiglia YM. Effects on mother and fetus of epidural and combined spinal-epidural techniques for labor analgesia. Rev Assoc Med Bras (1992). 2009;55(4):405–409. doi:10.1590/S0104-42302009000400014 - DOI - PubMed
    1. Boulier V, Gomis P, Lautner C, Visseaux H, Palot M, Malinovsky JM. Minimum local analgesic concentrations of ropivacaine and levobupivacaine with sufentanil for epidural analgesia in labour. Int J Obstet Anesth. 2009;18(3):226–230. doi:10.1016/j.ijoa.2009.02.002 - DOI - PubMed

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