Epidural sufentanil for postsurgical pain relief.

Abstract

This study aimed to determine the safest and most effective dose of sufentanil for epidural administration to relieve post-operative pain. Thirty healthy patients were treated following abdominal surgery. They received no opiates in premedication nor peroperatively. After surgery, upon occurrence of pain, they received a single epidural injection of sufentanil (30, 50 or 75 micrograms) according to a randomized protocol. Pain intensity was evaluated using a visual analogue scale (VAS). Arterial blood gases, peak flow (PF) and forced vital capacity (FVC) were measured before, and at 1, 2 and 4 h post-operatively. The onset of the analgesic effect was evident within 5 min, and was significantly faster with 75 micrograms sufentanil than with either of the other two doses (P less than 0.05). The maximal effect occurred at 30 min, and lasted for 4 h (VAS less than 5) irrespective of the dose injected. Respiratory rate decreased at most by 24% and post-operative sedation was increased for approximately 2 h, both effects being dose-related. Arterial PCO2, heart rate and mean arterial pressure remained normal. Two hours after the injection, there was a small increase in FVC and PF.