Key result
Ropivacaine combined with sufentanil significantly shortened the time to reach the maximum block plane (9.79 vs 13.26 minutes) and prolonged analgesic maintenance compared to ropivacaine alone.
Why the study?
Does ropivacaine combined with sufentanil improve hemodynamics and reduce inflammation in parturients undergoing cesarean section compared to ropivacaine alone?
Cohort (n=135)
No
Does ropivacaine combined with sufentanil improve hemodynamics and reduce inflammation in parturients undergoing cesarean section compared to ropivacaine alone?
Absolute Event Rate: 9.79% vs 13.26%
p-value: p=<0.001
Ropivacaine combined with sufentanil provides better anesthesia, stabilizes hemodynamics, and reduces inflammation in parturients undergoing cesarean section compared to ropivacaine alone.
Combined ropivacaine-sufentanil may stabilize hemodynamics and blunt inflammation post-cesarean; leaves open confirmation via prospective randomized trials.
Background: This study aims to investigate the effect of ropivacaine combined with sufentanil on hemodynamics and expression levels of serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in parturients undergoing cesarean section. Methods: The clinical data of 135 parturients undergoing cesarean section were retrospectively collected. After anesthesia, 135 parturients were divided into observation group (68 cases) and control group (67 cases). The observation group was anesthetized with ropivacaine combined with sufentanil before operation, while the control group was anesthetized with ropivacaine. Anesthesia related indexes, hemodynamics at different times and arterial blood gas analysis indexes of the two groups were observed and recorded. The peripheral venous blood of the two groups was taken 1 day before delivery, 12 hours after delivery and 24 hours after delivery to detect expression levels of TNF-α and IL-6. The Apgar scores of the two groups of newborns were recorded at 1 and 5 minutes after delivery, respectively. Results: Compared with the control group, the observation group had a shorter time to reach the maximum block plane, a longer time to maintain analgesia, and a lower visual analog scale (VAS) score at 6 h postpartum (p < 0.05). Moreover, the mean arterial pressure (MAP) and heart rate (HR) during skin resection (T1) in the observation group were higher (p < 0.05), and the cardiac output (CO), stroke volume (SV) and systemic circulation resistance (SVR) during T1 and end of surgery (T2) in the observation group were higher (p < 0.05). PaCO2 was increased and PaO2 in the control group at T1 and T2 was decreased after anesthesia (p < 0.05). Compared with 1 day before delivery, the serum levels of TNF-α and IL-6 increased at 12 and 24 hours after delivery. Compared with the control group, the serum levels of TNF-α and IL-6 in the observation group were lower at 12 and 24 hours after delivery (p < 0.05). Conclusions: The anesthetic effect of ropivacaine combined with sufentanil before cesarean section is better, which can effectively stabilize the mean arterial pressure, heart rate and other hemodynamic indicators of the puerpera, inhibit the inflammation in the puerpera, and have no adverse effects on the newborn.
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Li et al. (2023) conducted a cohort in Parturients undergoing cesarean section (n=135). Ropivacaine combined with sufentanil vs. 0.75% ropivacaine (1-2 mL) alone was evaluated on Time to reach the maximum block plane (minutes) (p=<0.001). Ropivacaine combined with sufentanil significantly shortened the time to reach the maximum block plane (9.79 vs 13.26 minutes) and prolonged analgesic maintenance compared to ropivacaine alone.
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