title: Epidural ropivacaine 1% with and without sufentanil addition for Caesarean section.
abstract: BACKGROUND
  So far only ropivacaine concentrations of 0.5 and 0.75% have been used for Caesarean section. This prospective double-blind trial evaluated the anaesthetic quality of ropivacaine 1% with and without sufentanil addition.
  
  
  METHODS
  Three groups of patients (n=20 each) scheduled for an elective Caesarean section were studied. The patients received initially 120 mg ropivacaine, or 120 mg ropivacaine plus 10 microg or 20 microg sufentanil. Additional epidural ropivacaine was injected if necessary. Primary outcome parameter was time to achieve sensory block at T4. Moreover, pain intensity at delivery (visual analogue scale, VAS), incidence of maternal side-effects (hypotension, bradycardia, nausea, vomiting, shivering, pruritus), and neonatal outcome (Apgar score, neurologic and adaptive capacity score, umbilical cord blood-gas values) were recorded.
  
  
  RESULTS
  The onset time for the sensory block was not significantly different among the groups. Also, VAS scores at delivery did not differ significantly between the plain ropivacaine 1% group (18 +/- 29 mm), the 10-microg sufentanil group (1 +/- 5 mm), and the 20-microg sufentanil group (6 +/- 18 mm). The total dose of ropivacaine was significantly higher in the plain ropivacaine 1% group (145 +/- 19 mg) compared to the patients receiving additional 10 microg sufentanil (130 +/- 15 mg, P = 0.02) or 20 microg sufentanil (129 +/- 16 mg, P = 0.01). The incidence of maternal side-effects and neonatal outcome were similar in all groups.
  
  
  CONCLUSIONS
  Ropivacaine 1% alone provided sufficient analgesia. Sufentanil addition did not significantly improve the quality of epidural anaesthesia with ropivacaine 1.0% for Caesarean section.
authors.affiliation: Department of Anaesthesiology, Klinikum Minden, Minden, Germany. b.bachmann-m@klinikum-minden.de
authors.forename: B
authors.initials: B
authors.lastname: Bachmann-Mennenga
authors.forename: G
authors.initials: G
authors.lastname: Veit
authors.forename: J
authors.initials: J
authors.lastname: Biscoping
authors.forename: B
authors.initials: B
authors.lastname: Steinicke
authors.forename: M
authors.initials: M
authors.lastname: Heesen
mesh_terms: D000759:Adjuvants, Anesthesia / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D000577:Amides / Q000009:adverse effects; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D019162:Anesthetics, Combined; D000779:Anesthetics, Local / Q000009:adverse effects; D001034:Apgar Score; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D016343:Monitoring, Intraoperative; D010147:Pain Measurement; D011247:Pregnancy; D011256:Pregnancy Outcome; D000077212:Ropivacaine; D017409:Sufentanil / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000759:Adjuvants, Anesthesia; D000577:Amides; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077212:Ropivacaine; D017409:Sufentanil