Effects of epidural analgesia with sufentanil on the mother and the newborn in labor

Objective To study the effects of epidural analgesia with ropivacaine plus sufentanil on the mother and the newborn using patient-controlled epidural analgesia in labor and make sure the most appropriate concentration of them.Methods 100 parturients who requested analgesia were randomly assigned to five groups(n=20 in the each group).Group F(group Ct),0.1% ropivacaine plus 2 μg/ml fentanyl,Experimental groups:S1,0.1% ropivacaine plus 0.3 μg/ml sufentanil.S2,0.1% ropivacaine plus 0.4μg/ml sufentanil.S3,0.1% ropivacaine plus 0.5μg/ml sufentanil.S4,0.1% ropivacaine plus 0.75 μg/ml sufentanil.All patients with cervical dilatation of 3-4cm received the solution of epidural anesthetic of ropivacaine plus sufentanil or fentanyl 10～15 ml.The PCEA were initiated after epidural anesthetia 30 min,injected anesthetic solution as above each group.The following data were collected:The vital signs,BP,HR of parturients,fetus heart rate,concentration of NO of mother at pre-analgesia and post-analgesia,and concentration of NO of umbilical venous blood,Visual analogue score(VAS),the onset and perfect time of analgesia,Bromage motor score of block after analgesia,labor duration,mode of delivery,Apgar scores,side effects.Results There was no difference at fetus heart rate between pre-analgesia and post-analgesia(P0.05).There were no significant differences in concentration of NO of mother among five groups.And so on of umbilical venous blood.The VAS at 5 min and 10 min in the S2、S3 and S4 groups were lower than those in the S1 and F group(P0.05),At 30 min in the F、S2、S3 and S4 groups,VAS were lower than that in the S1 group(P0.05).There were no differences of VAS at the other time intervals(60min,90min)among five groups(P0.05).The onset and perfect time of analgesia in S2、S3 and S4 were faster than those S1 and F(P0.05);Motor block did not occur in any patient.The duration of labor、the mode of delivery、the incidence of cesarean、usage of oxytocin and neonatal Apgar scores were similar among five groups The incidence of pruritus was significantly higher in group S4 than others'.Conclusion In five groups,there are litter influence of epidural analgesia for circulation on the mother and infants in labor.0.1% ropivacaine plus 0.4μg/ml sufentanil is the best dosage among five groups with litter side effects worth clinically extensive application in obstetrics.