title: Sparing effects of sufentanil on epidural ropivacaine in elderly patients undergoing transurethral resection of prostate surgery.
abstract: OBJECTIVE
  This study examined the sparing effect of sufentanil on the median effective concentration (EC₅₀) of epidural ropivacaine in elderly patients undergoing elective transurethral resection of prostate (TURP).
  
  
  METHODS
  This was a prospective randomized double-blind dose-response study. Fifty eight elderly patients with American Society of Anesthesiologists physical status I-II who were scheduled for TURP surgery under epidural anesthesia were randomly allocated to a group receiving 15 mL of ropivacaine (group R) or a group receiving ropivacaine plus 5 μg of sufentanil (group RS). The concentration of ropivacaine was determined by a Dixon's up-and-down sequential allocation. The first participant received 0.3% of ropivacaine in both groups and subsequent concentrations were determined by the response of the previous patient in the same group. The EC₅₀ of epidural ropivacaine was analyzed using the Dixon and Massey method.
  
  
  RESULTS
  The EC₅₀ of ropivacaine during TURP surgery was 0.186% (95% confidence interval, 0.173-0.200%) in group R, and 0.136% (95% confidence interval, 0.127-0.144%) in group RS (p<0.01). No differences in Bromage scale of motor block examination and the onset time of sensory block were observed.
  
  
  CONCLUSIONS
  Administration of 5 μg of epidural sufentanil caused a 37% reduction in the EC₅₀ of epidural ropivacaine in elderly patients who underwent TURP surgery. Thus, sufentanil addition during surgery of TURP can decrease the dose of ropivacaine anesthesia required.
authors.affiliation: Department of Anesthesiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.
authors.forename: Huiling
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.; Department of Anesthesiology, Shaoxing People's Hospital, Shaoxing, Zhejiang, P.R. China.; Medical Research Center, Shaoxing People's Hospital, Shaoxing, Zhejiang, P.R. China. yuh_li@qq.com.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Shaoxing People's Hospital, Shaoxing, Zhejiang, P.R. China.
authors.forename: Rui
authors.initials: R
authors.lastname: He
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000008:administration & dosage*; D000767:Anesthesia, Epidural / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D000077212:Ropivacaine; D017409:Sufentanil / Q000008:administration & dosage*; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D017409:Sufentanil
keywords: Ropivacaine; elderly patients; sufentanil
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