Journal
BMC PREGNANCY AND CHILDBIRTH
Volume 22, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s12884-022-04912-8
Keywords
Programmed intermittent epidural bolus; Labor analgesia; Optimal effective dose; Ropivacaine; Sufentanil
Categories
Funding
- Scientific Research Project of Health Commission of Sichuan Province [19PJ156]
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This study assessed the effectiveness of programmed intermittent epidural bolus (PIEB) with different concentrations of ropivacaine and sufentanil in obstetric analgesia. It found that the optimal bolus volume for 0.075% ropivacaine and 0.5 mu g/mL sufentanil was 10 mL, while for 0.1% ropivacaine and 0.5 mu g/mL sufentanil was 9 mL, with a 40-minute interval.
Background and objectives: To date, programmed intermittent epidural bolus (PIEB) has been widely used in obstetric analgesia, while no optimal PIEB regimen has been proposed. This study aimed to assess effective analgesia in 90% of women (EV90) with different concentrations of ropivacaine (0.075% and 0.1%) combined with 0.5 mu g/mL sufentanil, at an interval of 40 min using the biased coin design-up-and-down method (BCD-UDM), and to explore whether there is a difference in EV90 with the increase of ropivacaine concentration. Methods: In total, 103 primiparous women were assigned to two groups, including group A (n = 52) and group B (n = 51). Parturients in group A were treated with 0.075% ropivacaine and 0.5 mu g/mL sufentanil, while those in group B were treated with 0.1% ropivacaine and 0.5 mu g/mL sufentanil. Used the biased coin up-and-down sequential allocation method to determine the EV90. The secondary outcomes were sensory block level, motor block, and adverse events (hypotension, urinary retention, and pruritus). Results: The results revealed that EV90 was 10 mL (95% confidence interval (CI):8.03-11.54) in group A, and EV90 was 9 mL (95% CI:7.49-10.51) in group B by the isotonic regression method. The highest level of the sensory block was T8, and the lowest was T12. No case of hypotension was recorded,and only 4 parturients complained of motor block. Conclusion: With an interval of 40 min, the optimal PIEB bolus volume of 0.075% ropivacaine and 0.5 mu g/mL sufentanil was 10 mL, 0.1% ropivacaine and 0.5 mu g/mL sufentanil was 9 mL. Moreover, the PIEB volume decreased along with the higher concentration of ropivacaine.
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