Intrathecal sufentanil as the sole agent in combined spinal-epidural analgesia for the ambulatory parturient

To compare the effect of a combination of intrathecal (i.t.) sufentanil plus bupivacaine with i.t. sufentanil alone, on the incidence of hypotension and the success of ambulation in parturients.

This was a controlled, double-blind prospective trial involving 50 parturients in early labour who had received combined spinal-epidural analgesia (CSE). They were divided equally into two groups; group A received 10 micrograms i.t. sufentanil while group B received i.t. 10 micrograms sufentanil plus 2.5 mg plain bupivacaine. The blood pressure, pain scores, the highest sensory block and the degree of motor blockade were documented over the first 30 min by an unbiased anaesthetist. The ability and the desire to ambulate was studied 30 min after CSE. The side effects were documented throughout labour.

Group B had a higher incidence of hypotension; (12 vs 3: P < 0.01). Fewer parturients in group B could ambulate (19 vs 25: P < 0.05). Group B also had a higher sensory blockade than group A (median T4 VS T7-8: P < 0.01). Of all the 44 parturients who could ambulate, 13 desired not to do so, usually due to sedation.

The quality of analgesia in all subjects in the study was excellent. Side effects were more common in the i.t. sufentanil-bupivacaine combination group.