Efeitos Adversos do Sufentanil Associado ao Anestésico Local pelas Vias Subaracnóidea e Peridural em Pacientes Submetidas à Analgesia de Parto* Side Effects of Subarachnoid and Epidural Sufentanil Associated with a Local Anesthetic in Patients Undergoing Labor Analgesia

SUMMARY Salem ICF, Fukushima FB, Nakamura G, Ferrari F, Navarro LC, CastigliaYMM, Ganem EM — Side Effects of Subarachnoid and EpiduralSufentanil Associated with a Local Anesthetic in Patients UndergoingLabor Analgesia. BACKGROUND AND OBJECTIVES: The association of an opioidwith a local anesthetic improves the quality of labor analgesia andreduces the risk of systemic toxicity of the local anesthetic. However,opioids are not devoid of side effects. The aim of this study was tocompare the side effects of subarachnoid sufentanil associated withbupivacaine to those caused by epidural sufentanil associated withropivacaine in the doses used in the Anesthesiology Department inpregnant women undergoing labor analgesia. METHODS: Sixty pregnant women, ASA physical status I and II, agesbetween 15 and 42 years, at term and with healthy fetuses, undergoinglabor analgesia were enrolled in this study. They were randomly dividedin two groups: G1 — combined spinal epidural anesthesia — 0.5%bupivacaine (2.5 mg) and subarachnoid sufentanil (5 µg); G2 —Epidural Block — 0.2% ropivacaine (20 mg), and epidural sufentanil(10 µg). Complementary doses of 0.2% ropivacaine (12 mg) were admi-nistered whenever necessary, and 1% ropivacaine (50 mg) wasadministered for labor resolution. Patients were evaluated after anal-gesia (M1) regarding the presence of hypotension, maternal bradycar-dia, pruritus, nausea, vomiting, respiratory depression, and sedation.They were also evaluated postoperatively (M2) regarding the presenceof nausea, vomiting, pruritus, sedation, urinary retention, and pain.Newborns were evaluated by the Apgar score. The test t Student, Mann-Whitney test, and Chi-Square test were used for the statistical analysis.