Sufentanil in combination with low-dose hyperbaric bupivacaine in spinal anesthesia for cesarean section: a randomized clinical trial

Dourado, Alexandre Dubeux; Lins Filho, Ruy Leite de Melo; Fernandes, Raphaella Amanda Maria Leite; Gondim, Marcelo Cavalcanti de Sá; Nogueira, Emmanuel Victor Magalhães

doi:10.1016/j.bjane.2015.05.002

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Scientific Articles • Rev. Bras. Anestesiol. 66 (6) • Nov-Dec 2016 • https://doi.org/10.1016/j.bjane.2015.05.002 copy

Sufentanil in combination with low-dose hyperbaric bupivacaine in spinal anesthesia for cesarean section: a randomized clinical trial

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

A double blind randomized clinical trial of sufentanil as an adjunct in spinal anesthesia for cesarean section and, thereby, be able to reduce the dose of bupivacaine, a local anesthetic, with the same result of an anesthetic block with higher doses but with fewer perioperative side effects, such as hypotension.

KEYWORDS
Sufentanil; Spinal anesthesia; Bupivacaine; Hyperbaric; Cesarean section

	Group A (n = 44)		Group S ( n = 47)
	Mean	SD	Mean	SD	p ^a a Student's t-test.
Age (years)	26.0227	6.36	27.34	5.99	0.3114
BMI (kg m⁻²)	30.64	6.36	32.13	5.43	0.2322
Gestational age (weeks)	37.9373	2.32	38.31	1.95	0.3976

	Group A		Group S
	n = 44	%	n = 47	%	p ^a a Chi-square test.
Puncture level					0.5436
L2–L3	4	9.09%	2	4.26%
L3–L4	37	84.09%	43	91.49%
L4–L5	3	6.82%	2	4.26%

Needle					0.6615
25G	14	31.82%	17	36.17%
27G	30	68.18%	30	63.83%

	Group A (n = 44)		Group S ( n = 47)
	Mean	SD	Mean	SD	p ^a a Student's t-test.
Duration of birth (min)	14.16	4.8	14.51	4.7	0.7252
Duration of surgery (min)	56.06	11.75	57.21	10.88	0.6307

	Group A (n = 44)		Group S (n = 47)
	n	%	n	%
Yes	30	68.18	36	76.6
No	14	31.82	11	23.4

	Group A (n = 44)		Group S ( n = 47)
	n	%	n	%
Up to 5 min	31	70.45	40	85.11
6–10 min	9	20.45	3	6.38
11–15 min	1	2.27	3	6.38
>15 min or not reached	3	6.82	1	2.13

	Group A (n = 44)		Group S ( n = 47)
	n	%	n	%	p
Hypotension	36	81.82	37	78.72	0.7111^a a Chi-square.
Bradycardia	19	43.18	28	59.57	0.1178^a a Chi-square.
Nausea	17	38.64	16	34.04	0.6487^a a Chi-square.
Vomiting	9	20.45	6	12.77	0.3232^a a Chi-square.
Pruritus	2	4.55	17	36.17	^c c p < 0.05. 0.0001^b b Fisher's exact.
SpO₂ < 95%	3	6.82	1	2.13	0.3504^b b Fisher's exact.
Drowsiness	0	0	11	23.4	^c c p < 0.05. 0.0005^b b Fisher's exact.
Abdominal discomfort	5	11.36	1	2.13	0.1032^b b Fisher's exact.
Pain	1	2.27	1	2.13	1.0^b b Fisher's exact.

Valor	Apgar, 1 min^a a p = 0.6663; Fisher's exact.				Apgar, 5 min^b b p = 1; Chi-square
	Group A (n = 44)		Group S ( n = 47)		Group A ( n = 44)		Group S ( n = 47)
	n	%	n	%	n	%	n	%
<7	2	4.55	2	4.26	–	–	–	–
7–10	48	95.45	45	95.74	44	100	47	100

	Group A (n = 44)		Group S ( n = 47)		p
	n	%	n	%
Pruritus
After 2 h^c c p < 0.05.	13	30.23	29	61.7	0.0027^a a Chi-square. , ^c c p < 0.05.
After 6 h	13	30.23	18	38.3	0.4212^a a Chi-square.
After 12 h	6	13.95	8	17.02	0.6883^a a Chi-square.

Nausea
After 2 h	5	11.63	5	12.77	0.8692^a a Chi-square.
After 6 h	3	6.98	4	8.51	0.5502^b b Fisher's exact.
After 12 h	4	9.3	1	2.13	0.1538^b b Fisher's exact.

Vomiting
After 2 h	1	2.33	4	8.51	0.2094^b b Fisher's exact.
After 6 h	1	2.33	4	8.51	0.2094^b b Fisher's exact.
After 12 h	0	0	0	0	–

	Group A (n = 44)		Group S ( n = 47)		p
	n	%	n	%
After 2 h	3	6.82	4	8.51	0.5372^b b Fisher's exact.
After 6 h	8	18.18	3	6.38	0.0795^b b Fisher's exact.
After 12 h	13	29.55	13	27.66	0.0396^a a Chi-square. , ^c c p < 0.05.

Sociedade Brasileira de Anestesiologia R. Professor Alfredo Gomes, 36, 22251-080 Botafogo RJ Brasil, Tel: +55 21 2537-8100, Fax: +55 21 2537-8188 - Campinas - SP - Brazil
E-mail: bjan@sbahq.org

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[1] * Corresponding author. E-mail:rafa.amanda120@gmail.com (R.A. Fernandes).