| OBJECTIVE:We studied the quality of the block and its maternal-fetal repercussions when different doses of sufentanil were combined with hyperbaric ropivacaine using the intrathecal route in pregnant women undergoing caesarean section and tried to find the optimum dose of intrathecal sufentanil.METHODS:This was a prospective,randomized,controlled trial with 80 pregnant women,ASAâ… -â…¡,who were scheduled for elective caesarean section under subarachnoid block.Patients were distributed into four groups according to the dose of sufentanil used:no sufentanil(Group A,control) or 2.5,or 5.0 or 7.5 microg sufentanil(Groups B,C,D, respectively).In every group,the local anaesthetic used was 1.5ml 0.75% ropivacaine(11.25mg),and the total volume of the solution was made to 2.5 mL with 10%glucose injection.The BP,HR,SpO2,ECG before and after anesthesia induction were recorded.The maximum level of sensory block,motor block level,duration of analgesia,maternal side-effects and maternal-fetal cardiovascular repercussions were evaluated.The first and fifth minute's Apgar score were evaluated by midwife.RESULTS:Anesthesia quality was improved significantly in experiment groups compared to control group.Groups C and D could offer adequate anesthesia with low-dose ropivacaine in caesarean section spinal anesthesia.Postoperation analgesia was significantly prolonged in Groups C and D.Compared with Group C,the occurrence of pruritus was significantly higher and much more severe in the group D which received sufentanil 7.5 microg,but didn't prolong analgesia much more.With the exception of pruritus,no differences were observed between groups with respect to cardiovascular or other maternal effects.CONCLUSIONS:The addition of sufentanil 5.0 and 7.5 microg to low-dose hyperbaric ropivacaine provided adequate anaesthesia for caesarean section and good postoperative analgesia.Sufentanil of 5.0ug may be the optimum dose because it has a good balance between analgesia and side-effect.
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