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Maternal and neonatal effects of adding epidural sufentanil to 0.5% bupivacaine for cesarean delivery
J D Vertommen1, H Van Aken, E Vandermeulen
1Department of Anesthesiology, Katholieke Universiteit Leuven, Belgium.
Study Objective:
To determine the maternal and fetal effects of the addition of epidural sufentanil to 0.5% bupivacaine for cesarean delivery.
Design:
Randomized, double-blind, prospective study.
Setting:
University Hospitals, Katholieke Universiteit Leuven, Leuven, Belgium.
Patients:
Sixty women at term scheduled for elective cesarean section, all of whom had elected epidural anesthesia.
Interventions:
The 60 women were divided into three groups of 20, with each group receiving a different 1 ml study solution: saline (control) or sufentanil 20 micrograms or sufentanil 30 micrograms added to 0.5% bupivacaine and epinephrine (1:200,000).
Measurements And Main Results:
In the mother, the quality of anesthesia, the duration of postoperative analgesia, the volume of anesthetic, and the frequency of side effects were examined. The neonates were evaluated at 5 and 10 minutes after birth by Apgar scores and between 60 and 120 minutes after birth by both the screening test developed by Prechtl and the Neurological and Adaptive Capacity Scoring System. Immediately after delivery, maternal and umbilical vein blood were drawn and assayed for sufentanil levels. Adding sufentanil significantly improved the quality of anesthesia without depressing the neurobehavioral status of the baby.
Conclusion:
The epidural injection of sufentanil added to 0.5% bupivacaine with epinephrine improved the quality of anesthesia during elective cesarean section without jeopardizing the safety of the baby.