Visceral pain is common during
epidural anesthesia with mini dose
local anesthetics in parturients during
cesarean section. To reduce or avoid this complication caused by
traction on the abdominal viscera, this study aimed to determine the 50% effective dose (ED50) and 95% effective dose (ED95) of epidural
sufentanil as an adjuvant combination with
local anesthetics for relief
visceral pain in parturients with scarred uterus undergoing elective
cesarean section.One hundred parturients with scarred uterus undergoing elective
cesarean section under
epidural anesthesia were enrolled in this randomized, double-blinded, dose-ranging study. Parturients received 5, 10, 15, 20, and 25 μg epidural
sufentanil as an adjuvant with 10 mL of 0.65%
ropivacaine. Successful
epidural anesthesia was defined as a sixth thoracic vertebra (T6) sensory level achieved within 20 minutes after epidural drugs administration and/or no
visceral pain by
traction on the abdominal viscera during the
cesarean section. The ED50 and ED95 were calculated with a logistic regression model.ED50 and ED95 of epidural
sufentanil for successful of the
pain-free from
visceral pain were 10.7 μg [95% confidence interval (CI): 2.4-14.4 μg) and 28.1 μg (95% CI: 19.4-44.0 μg), respectively. The onset time to sensory block, maximum Bromage scale and duration of motor block were significant different with dose of
sufentanil >20 μg (P < .05, compared with the other dose groups). With the dose of epidural
sufentanil >20 μg could result in an increase of incidence of maternals' adverse effects. Compared with a different dose of
sufentanil, epidural administed
sufentanil between 15 μg and 20 μg can maximize parturients' satisfaction.Our study showed that
sufentanil could be used in combination with
ropivacaine for relief from somato-
visceral pain in patients with scarred uterus during elective
cesarean section during
epidural anesthesia, and that maximized parturients' satisfaction could be achieved when the use of
sufentanil with the dose between 15 μg and 20 μg for
epidural anesthesia.