Combination of intrathecal sufentanil 10 mu g plus bupivacaine 2.5 mg for labor analgesia: Is half the dose enough?

This controlled, double-blinded, prospective trial of 42 parturients in ear ly labor was conducted to determine whether halving the total amount of int rathecal (IT) sufentanil and bupivacaine reduced the incidence of systemic hypotension while providing adequate analgesia with minimal lower limb moto r block. Combined spinal-epidural analgesia (CSE) was instituted; Group A ( n = 21) received a total of 10 mu g of sulfentanil plus 2.5 mg of bupivacai ne, whereas Group B (n = 21) received half that dose. Compared with Group B , Group A had a higher incidence of hypotension (nine parturients in Group A, two in Group B; P < 0.05), a greater degree of motor block (P < 0.05), a nd a higher incidence of sedation (nine parturients in Group A were sedated , one in Group B; P < 0.01). Group B had higher pain scores for the first 5 min (P < 0.05) and a lower level of sensory blockade (median of T7 in Grou p B compared with T4 in Group A; P < 0.01). We conclude that halving the to tal amount of IT 10 mu g of sufentanil plus 2.5 mg of bupivacaine is a suit able option for CSE in labor because it reduces the incidence of some side effects, such as hypotension and maternal sedation, without compromising ov erall high maternal satisfaction. Implications: We showed that adequate lab or pain relief could be provided by halving the recommended dose of 10 mu g of intrathecal sufentanil plus 2.5 mg of bupivacaine. The larger dose, how ever, produced faster pain relief, which lasted longer than the reduced dos e. The mother and baby were not adversely affected with either dose.