Related Experiment Video
Updated: Aug 15, 2026
03:59
Targeting Gray Rami Communicantes in Selective Chemical Lumbar Sympathectomy
Published on: January 10, 2019
Intrathecal sufentanil for labor analgesia does not cause a sympathectomy
E T Riley1, D Walker, C L Hamilton
1Department of Anesthesia, Stanford University School of Medicine, California 94305, USA. edriley@Leland.Stanford.edu
Anesthesiology
|November 14, 1997
Summary
Intrathecal sufentanil (ITS) for labor analgesia does not cause a sympathectomy, as evidenced by stable peripheral temperatures. This suggests that blood pressure changes after ITS are not due to sympathectomy.
Area of Science:
- Anesthesiology
- Obstetrics
- Pharmacology
Background:
- Intrathecal sufentanil (ITS) is commonly used for labor analgesia.
- Observed blood pressure and sensory changes suggest ITS might cause sympathectomy.
- This study investigated whether ITS induces sympathectomy by measuring temperature changes.
Purpose of the Study:
- To determine if intrathecal sufentanil (ITS) causes a sympathectomy in laboring women.
- To compare temperature changes after ITS with those in a control group receiving spinal bupivacaine for cesarean section.
Main Methods:
- Twenty parturients received either 10 microg ITS for labor analgesia or 12 mg bupivacaine for spinal anesthesia.
- Central, calf, and great toe temperatures were measured. Calf-to-toe (C-T) temperature indices were calculated.
- A decrease in C-T index indicates vasodilation and sympathectomy.
Main Results:
- No significant changes in C-T indices or central temperature were observed in the sufentanil group.
- Significant decreases in C-T indices and central temperature were noted in the bupivacaine group.
- These findings indicate sympathectomy in the bupivacaine group but not the sufentanil group.
Conclusions:
- The lack of temperature change in the sufentanil group suggests no significant vasodilation or sympathectomy occurred.
- The observed decreases in the bupivacaine group confirm sympathectomy from spinal anesthesia.
- Blood pressure decreases after intrathecal sufentanil for labor analgesia are unlikely due to sympathectomy.
Related Concept Videos
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
01:24General Anesthesia: Overview
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
01:24Parenteral Anesthetics: Overview
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.