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The effects of sufentanil or morphine added to hyperbaric bupivacaine in spinal anaesthesia for Caesarean section

Karaman, S.*; Kocabas, S.*; Uyar, M.*; Hayzaran, S.*; Firat, V.*

European Journal of Anaesthesiology: April 2006 - Volume 23 - Issue 4 - p 285–291
doi: 10.1017/S0265021505001869
Original Article

Background and objective:: The quality of spinal anaesthesia, often used for Caesarean section, can be improved by adding an opioid to the local anaesthetic. This study compared the quality of anaesthesia, postoperative analgesia, and adverse effects on mother and neonate when either sufentanil 5 μg or morphine 0.2 mg was added to intrathecal hyperbaric bupivacaine for Caesarean section.

Methods:: This prospective, randomized and double‐blind study encompassed 54 females undergoing Caesarean section. Spinal anaesthesia was obtained with 2 mL of 0.5% bupivacaine supplemented with either 0.2 mg morphine or 5 μg sufentanil. Characteristics of spinal block, intraoperative analgesia, maternal and neonatal side‐effects and the time to first request for analgesics were assessed.

Results:: There were no differences in the onset time of sensory block, time to sensory block to T10, time to highest sensory block, highest sensory block level, time to regression of sensory block to T10 level and time to resolution of motor blockade. Perioperative haemodynamic parameters, neonatal Apgar scores, neurological and adaptive capacity scores, umbilical blood gas values, sedation scores, nausea–vomiting and pruritus incidences were similar in both groups. The time to the first request for an analgesic was significantly longer (19.5 ± 4.7 h vs. 6.3 ± 5.2 h) in patients given morphine (P < 0.05).

Conclusions:: The addition of 5 μg sufentanil or 0.2 mg morphine to hyperbaric bupivacaine for Caesarean section both provided safe and effective anaesthesia. Morphine increased the duration of postoperative analgesia compared with sufentanil without increasing maternal or neonatal side‐effects.

*Ege University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Izmir, Turkey

Correspondence to: Semra Karaman, Department of Anaesthesiology and Reanimation, Ege University Faculty of Medicine, Bornova, Izmir, 35100 Turkey. E‐mail: skaraman@med.ege.edu.tr; Tel: +90 232 374 1040; Fax: +90 232 339 7687

Accepted for publication 20 November 2005

First published online 27 January 2006

© 2006 European Society of Anaesthesiology