EPIDURAL SUFENTANIL DOES NOT ATTENUATE THE CENTRAL HEMODYNAMIC-EFFECTS OF CESAREAN-SECTION PERFORMED UNDER EPIDURAL-ANESTHESIA

The effect of sufentanil 30 mu g added to the epidural local anaesthet ic solutions used for anaesthesia during elective Caesarean section on central haemodynamic variables was studied. Haemodynamic measurements made by thoracic electrical bioimpedance (TEB) monitoring were compar ed in 21 healthy parturients undergoing Caesarean section under epidur al anaesthesia with and without the addition of epidural sufentanil. T he patients were randomized to control (Group C) and study (Group S) g roups. Following iv prehydration, an epidural catheter was placed at t he L(2-3) Or L(3-4) interspace. After a negative test dose, in a doubl e-blinded protocol, patients in Group S received sufentanil 30 mu g (0 .6 ml) in 4.4 ml lidocaine carbonate 2% with 5 mu g.ml(-1) epinephrine and those in Group C received 5 mi lidocaine carbonate 2% with epinep hrine. Lidocaine carbonate 2% with 5 mu g ml(-1) epinephrine was then titrated to establish an anaesthetic level of T-4. Haemodynamic variab les (heart rate, mean arterial blood pressure, cardiac index, ejection fraction and end-diastolic index) were measured non-invasively, conti nuously throughout the perioperative period. There were no differences noted in haemodynamic measurements between the groups at any time per ioperatively. However, differences occurred within the groups when com pared with baseline values. Heart rate was increased in both groups in traoperatively. Cardiac index war; increased throughout the intraopera tive period in Group S but war; less frequently elevated in Group C. E jection fraction was increased throughout the perioperative period in Group S but not in Group C. End-diastolic index increased following iv preloading in both groups and returned to baseline with induction of epidural block. Maternal haemodynamic measurements as assessed by TEB monitoring, during Caesarean section, were not altered by the addition of 30 mu g sufentanil to carbonated lidocaine for lumbar epidural ana esthesia.