POTENTIATION OF SUFENTANIL BY CLONIDINE IN PCEA WITH OR WITHOUT BASALINFUSION

Sufentanil or a sufentanil-clonidine combination was evaluated to dete rmine whether the basal rate in patient-controlled epidural analgesia (PCEA) might affect the daily consumption, quality of analgesia or inc idence of side effects. Following Caesarean section delivery, 60 patie nts were randomly assigned to receive one of the four following PCA re gimens (15 patients per group) for the relief of post-operative pain b y the epidural route: sufentanil 2 mu g mL(-1) in 0.9% NaCl, demand do se 5 mu g i.e. 2.5 mL, (group S+ with, group S without an infusion at 2.5 mL hr(-1)) or sufentanil 2 mu g mL(-1) + clonidine 3 mu g mL(-1), demand dose 5 mu g sufentanil + 7.5 mu g clonidine i.e. 2.5 mL (group SC+ with and SC without an infusion of 2.5 ml hr(-1)). The other PCA s ettings (Bard I PCA pump) were a lock out interval of 10 min and a 1 h limit of 20 mu g sufentanil and 30 mu g clonidine i.e. 10 mL. The par ameters measured were the analgesic drug consumption and number of dos e demands during the first 24 h, pain scores at 6 h intervals, side ef fects and quality of sleep. The concurrent infusion increased the dose requirements regardless of the content of the syringe. Consumption of sufentanil was the highest in those patients receiving the plain solu tion with a basal infusion. Clonidine addition reduced the dose requir ements but only significantly in those receiving the background infusi on. Patients treated with the mixture tended to reach lower pain score s than those receiving sufentanil only without basal rate. Patients re ceiving the mixture with basal rate requested significantly fewer addi tional demands compared with the three other groups, but this did not influence the quality of sleep. Since side effects were more frequentl y registered in the patients in this group, it was concluded that the optimum regimen was the sufentanil-clonidine combination but with dele tion of the basal rate.