Clinical observation of small-dose bupivacaine combined with sufentanil for emergency cesarean section under subarachnoid block anesthesia

Objective To study the feasibility of small-dose bupivacaine combined with sufentanil in emergency cesarean section under subarachnoid block anesthesia. Methods Eighty singleton parturients (American Society of Anesthesiologists grade Ⅰor Ⅱ) with a gestation period of more than 37 weeks for emergency cesarean section were randomly divided into two groups (n=40). In group BS, 0.5% bupivacaine (6 mg) and sufentanil (5 μg) were applied and 0.5% bupivacaine (10 mg) was used in group B. Subarachnoid block anesthesia was performed at L2—L3 interspace. Mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia (T0), 5 min (T1), 10 min (T2), 15 min (T3) and 30 min (T4) after anesthesia and at the end of the surgery (T5). After subarachnoid block anesthesia, analgesic level, onset time of sensory blockade, anesthetic effect, and 1-min and 5-min Apgar scores in newborns were also recorded. The incidence rates of side effects such as intraoperative hypotension, nausea and vomiting, chill and the use of ephedrine were evaluated. Results MAP at T1—T5 was significantly lower than those at T0 in group B (P0.05), while MAP in group BS was significantly higher than those in group B at T1—T5 (P0.05). There was no significant difference in HR between two groups and among all time points in each group (P0.05). Analgesic level after subarachnoid block anesthesia in group BS was significantly lower than that in group B (P0.05), but there was no significant difference in onset time of sensory blockade between the two groups (P0.05). The application of ephedrine and the incidences of hypotension, nausea and vomiting and chill in group BS were significantly lower than those in group B (P0.05). There were no significant differences in anesthetic effect or in 1-min and 5-min Apgar scores between the two groups (P0.05). Conclusion The application of 0.5% bupivacaine (6 mg) combined with sufentanil (5 μg) in emergency cesarean section under subarachnoid block anesthesia offers satisfactory anesthetic effect and few side effects in pregnant women with steady hemodynamics. It is a safe and effective anesthetic method.