title: The Dose-response of Intrathecal Ropivacaine Co-administered with Sufentanil for Cesarean Delivery under Combined Spinal-epidural Anesthesia in Patients with Scarred Uterus.
abstract: BACKGROUND
  Spinal anesthesia is considered as a reasonable anesthetic option in lower abdominal and lower limb surgery. This study was to determine the dose-response of intrathecal ropivacaine in patients with scarred uterus undergoing cesarean delivery under combined spinal-epidural anesthesia.
  
  
  METHODS
  Seventy-five patients with scarred uterus undergoing elective cesarean delivery under combined spinal-epidural anesthesia were enrolled in this randomized, double-blinded, dose-ranging study. Patients received 6, 8, 10, 12, or 14 mg intrathecal hyperbaric ropivacaine with 5 μg sufentanil. Successful spinal anesthesia was defined as a T4sensory level achieved with no need for epidural supplementation. The 50% effective dose (ED50) and 95% effective dose (ED95) were calculated with a logistic regression model.
  
  
  RESULTS
  ED50and ED95of intrathecal hyperbaric ropivacaine for patients with scarred uterus undergoing cesarean delivery under combined spinal-epidural anesthesia (CSEA) were 8.28 mg (95% confidence interval [CI]: 2.28-9.83 mg) and 12.24 mg (95% CI: 10.53-21.88 mg), respectively.
  
  
  CONCLUSIONS
  When a CSEA technique is to use in patients with scarred uterus for an elective cesarean delivery, the ED50and ED95of intrathecal hyperbaric ropivacaine along with 5 μg sufentanil were 8.28 mg and 12.24 mg, respectively. In addition, this local anesthetic is unsuitable for emergent cesarean delivery, but it has advantages for ambulatory patients.
authors.forename: Fei
authors.initials: F
authors.lastname: Xiao
authors.forename: Wen-Ping
authors.initials: WP
authors.lastname: Xu
authors.forename: Yin-Fa
authors.initials: YF
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Liu
authors.forename: Xia
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Anesthesia, Jiaxing Maternity and Child Care Hospital; Jiaxing Genetic and Reproductive Medicine Research Institute, Jiaxing, Zhejiang 314050, China.
authors.forename: Li-Zhong
authors.initials: LZ
authors.lastname: Wang
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage / Q000627:therapeutic use*; D000767:Anesthesia, Epidural / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D002585:Cesarean Section / Q000379:methods*; D002921:Cicatrix; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D011247:Pregnancy; D000077212:Ropivacaine; D017409:Sufentanil / Q000008:administration & dosage / Q000627:therapeutic use*; D014599:Uterus / Q000473:pathology*
chemical_list: D000577:Amides; D000077212:Ropivacaine; D017409:Sufentanil