The Influence Of Sufentanil On Epidural Anesthetic Effect of Ropivacaine In Lower Limb Surgery

Abstract

Mukesh Kumar, Radheshyam Gupta, Binay Kumar Shah, Satish Gupta, Suman Gupta and Essa Ceesay

Background: The Effective dose of ropivacaine, alone for lower limb surgery is higher and can increase the risk of adverse effects. Sufentanil, a more lipophilic and higher analgesic opioid, has been found to reduce the dosage of ropivacaine. Therefore, in the present study, we compared the anesthetic effect, in terms of onset time to sensory block and duration of analgesia, of two different concentrations of ropivacaine, when administered alone or co-administered with sufentanil.

Methods: 80 consecutive American Society of Anesthesiologist physical status (ASA) Ι-ΙΙ patients who were scheduled for lower limb surgery under epidural anesthesia were enrolled and assigned to one of four different groups (20 patients in each): 0.3375% Ropivacaine alone (Group A1; GA1); 0.375%, Ropivacaine alone (Group A2; GA2); 0.3375% ropivacaine with 20 μg Sufentanil (Group B1; GB1); 0.375% Ropivacaine with 20 μg Sufentanil (Group B2; GB2), Anesthetic effects in terms of onset time to sensory block and analgesic duration as well as adverse effects were compared between groups, success rates with different groups were also assessed.

Results: The demographic parameters such as age, sex, body weight, etc., were not significantly different among groups. Although increasing concentrations of ropivacaine decrease onset time to sensory block and increase analgesic duration, the effects were not statistically significant (P> 0.05). However, addition of Sufentanil to each concentration of ropivacaine increases analgesic duration and decreases onset time to sensory block significantly, (GA1 vs GB1: P=0.012); (GA2 vs GB2: P=0.001). In addition, the success rate for each concentration of ropivacaine was also accentuated significantly by the addition of sufentanil. Except for GB2, none of the groups achieved 100% successful anaesthesia, which was significantly higher compared to other groups. There were no significant differences in hemodynamics and postoperative adverse reactions among any groups.

Conclusion: The minimum concentration of ropivacaine required to induce 100% satisfactory anesthesia was achieved with the concentration of 0.375%. Addition of Sufentanil to Ropivacaine significantly decreases onset time of epidural block and increases analgesic duration, irrespective of concentration of administered Ropivacaine. Moreover, addition of Sufentanil did not have any significant hemodynamic changes or any adverse effects in both groups.

PDF