INTRATHECAL SUFENTANIL AS THE SOLE AGENT IN COMBINED SPINAL-EPIDURAL ANALGESIA FOR THE AMBULATORY PARTURIENT

Purpose: To compare the effect of a combination of intrathecal (IT) su fentanil plus bupivacaine with IT sufentanil alone, on the incidence o f hypotension and the success of ambulation in parturients. Methods: T his was a controlled, double-blind prospective trial involving 50 part urients in early labour who had received combined spinal-epidural anal gesia (CSE). They were divided equally into two groups; group A receiv ed 10 mu g IT sufentanil while group B received IT 10 mu g sufentanil plus 2.5 mg plain bupivacaine. The blood pressure, pain scores, the hi ghest sensory block and the degree of motor blockade were documented o ver the first 30 min by an unbiased anaesthetist. The ability and the desire to ambulate was studied 30 min after CSE. The side effects were documented throughout labour. Results: Group B had a higher incidence of hypotension; (12 vs 3: P < 0.01). Fewer parturients in group B cou ld ambulate (19 vs 25: P < 0.05). Group B also had a higher sensory bl ockade than group A (median T-4 vs T7-8: P < 0.01). Of all the 44 part icipants who could ambulate, 13 desired not to do so, usually due to s edation. Conclusion: The quality of analgesia in all subjects in the s tudy was excellent. Side effects were more common in the IT sufentanil -bupivacaine combination group.