Mp. Vercauteren et al., POTENTIATION OF SUFENTANIL BY CLONIDINE IN PCEA WITH OR WITHOUT BASALINFUSION, European journal of anaesthesiology, 13(6), 1996, pp. 571-576
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.