Comparison of clinical effects of meperidine and sufentanil added to 0.5% hyperbaric bupivacaine for spinal anesthesia in patients undergoing cesarean delivery: a randomized controlled trial

• Published in: Journal of anesthesia Vol. 36; no. 2; pp. 201 - 209
• Main Authors: Kanawati, Saleh, Barada, Mohamad Ali, Naja, Zoher, Rajab, Omar, Sinno, Loubna, El Hasan, Janah
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01-04-2022; Springer
• Subjects: Anesthesia; Anesthesia, Obstetrical - adverse effects; Anesthesia, Spinal - adverse effects; Anesthesiology; Anesthetics, Local; Bupivacaine; Cesarean section; Clinical trials; Comparative analysis; Critical Care Medicine; Double-Blind Method; Emergency Medicine; Female; Humans; Intensive; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Meperidine; Nausea; NCT; NCT04446715; Original Article; Pain Medicine; Pregnancy; Product development; Sufentanil; Cesarean delivery; Meperidine; Sufentanil; Spinal anesthesia
• ISSN: 0913-8668; 1438-8359
• DOI: 10.1007/s00540-021-03031-6

Purpose
The objective of this study was to compare the effect of adding meperidine or sufentanil to hyperbaric bupivacaine in patients undergoing elective cesarean delivery (CD) under spinal anesthesia. The primary outcome was the first analgesic request time, and secondary outcomes included an analgesic requirement in the first 24 h and intraoperative and postoperative side effects.
Methods
This was a randomized, double-blind clinical trial in which patients were allocated into two groups. One group received preservative-free meperidine 12.5 mg (1 mL) in addition to 0.5% 10 mg (2 mL) of hyperbaric bupivacaine for spinal anesthesia. The other group received sufentanil 5 μg (1 mL) added to 0.5% 10 mg (2 mL) of hyperbaric bupivacaine.
Results
A total of 60 parturients were included in the study, 30 patients in each group. Time to first analgesic request was significantly longer in the meperidine group (400.0 ± 142.1 min) compared to (274.0 ± 104.1 min) in the sufentanil group (
P
 < 0.0001). Around 73% of the parturients in the sufentanil group required analgesics at 4 h compared to 13% in the meperidine group (
P
 < 0.0001). There were no significant differences in postoperative pruritus, nausea and vomiting, in addition to shivering. As for surgeon satisfaction, 56.7% reported excellent abdominal muscle relaxation during the surgery in the meperidine group compared to 10% in the sufentanil group (
P
 < 0.0001).
Conclusion
Meperidine was superior to sufentanil in terms of improved analgesia, intraoperative postoperative pruritus, and shivering, as well as increased surgeon satisfaction in women undergoing spinal anesthesia for elective cesarean delivery.
Clinical trial number and registry
ClinicalTrials.gov (NCT04446715).