90% effective volume of 0.1% ropivacaine combined with 0.4 µg/ml sufentanil for epidural labour analgesia with push pump at a rate of 400 mL/hr and a bolus interval of 30 min: a double-blind sequential dose-finding study

• Published in: BMC anesthesiology Vol. 24; no. 1; pp. 295 - 8
• Main Authors: Sun, Yuanqing, Ma, Wei, Xu, Tao, Zheng, Jing
• Format: Journal Article
• Language: English
• Published: England BioMed Central 27.08.2024; BMC
• Subjects: Adult; Amides - administration & dosage; Analgesia; Analgesia, Epidural - methods; Analgesia, Obstetrical - methods; Analgesics; Analgesics, Opioid - administration & dosage; Anesthetics, Local - administration & dosage; Cardiac arrhythmia; Catheters; Cervix; Childbirth & labor; Dose-Response Relationship, Drug; Double-Blind Method; Epidural; Female; Heart rate; Hormones; Humans; Hypotension; Infusion pumps; Labour Pain; Pain perception; Pregnancy; Ropivacaine; Ropivacaine - administration & dosage; Sufentanil; Sufentanil - administration & dosage; Time Factors; Young Adult; United States > US; China; Analgesia; Ropivacaine; Sufentanil; Labour Pain
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/s12871-024-02678-4

It was reported that either shorter programmed intermittent epidural bolus (PIEB) intervals or high-speed bolus can produce more extensive epidural spread. We hypothesized that a combination of shortened time interval and increased speed of epidural bolus might further improve analgesic effect and therefore reduce the hourly volume for epidural labour analgesia. This double-blind dose-finding study used a biased coin up-and-down sequential allocation method to determine the 90% effective bolus volume of ropivacaine combined with sufentanil while using the push pump at a rate of 400 mL/hr and interval of 30 min to provide effective analgesia without breakthrough pain. We used 0.1% ropivacaine with 0.4 µg/mL sufentanil, with bolus volumes ranging from 3 to 6 mL. The first patient was assigned a volume of 3 mL, and the remaining volumes were assigned according to the biased coin-up-and-down method. The estimated 90% effective volume (EV90) of ropivacaine combined with sufentanil for epidural labour analgesia at a time interval of 30 min was 4.88 mL (95% confidence interval 4.83-5.38). The optimum bolus volume of ropivacaine with sufentanil while using push pump at a time interval of 30 min is approximately 5 mL. It could probably further reduce the hourly bolus volume for epidural labour analgesia.