[Continuous peridural application of sufentanil for postoperative analgesia]

Efficacy and side effects of a continuous infusion of sufentanil following epidural administration of a single dose of 30 micrograms of the opioid were studied in 28 patients undergoing laparotomy. Patients were divided into two groups treated with either 10 micrograms/h (n = 13) or 15 micrograms/h (n = 15) and compared with regard to sufentanil plasma levels, side effects and changes in blood gases. The analgesic effect of 15 micrograms/h was slightly better than that of 10 micrograms/h. There were few side effects during continuous administration of the high- or low-dose sufentanil: in some cases nausea (4/13 and 1/15) and vomiting (3/13 and 1/15) occurred. After the injection of a bolus of 30 micrograms sufentanil, a dose chosen according to current recommendations, a quick onset of analgesia was noted, but also sedation and respiratory depression with apneic intervals lasting up to 30 s, demonstrating both the efficacy and the possibility of unwanted and even harmful side effects associated with this kind of administration. During long-term infusion, after about 20 h PaCO2 and respiratory rate were significantly different between the two groups, which could be explained by differences in sufentanil plasma levels and a somewhat higher level of postoperative pain in the group receiving 10 micrograms/h.