• G De Cosmo, P Primieri, E Adducci, M Fiorenti, and G Beccia.
• Department of Anesthesiology and Critical Care, Catholic University of Rome, Rome, Italy.
• Minerva Anestesiol. 2004 Jun 1;70(6):503-8.

AimCombining an opioid with peridural local analgesia is an excellent technique to control post-operative pain. Sufentanil is a widely used opioid agent, but its optimal dosage has not yet been defined. In this study we wanted to determine the best dose of epidural sufentanil in major surgery.MethodsBefore the operation, 45 major abdominal surgery patients received blended anesthesia through an epidural chest catheter. The patients were randomized into 3 groups of 15 subjects according to different sufentanil doses [0.2% ropivacaine combined with sufentanil at a dose of 0.5 microg/ml(-1), 0.75 microg/ml(-1), or 1 microg/ml(-1) (groups A, B and C, respectively)] administered through an epidural chest catheter connected to an elastometric pump (5 ml/h) for the first 36 postoperative hours. The level of postoperative analgesia in motion and at rest was measured using an analog visual scale (VAS-R, VAS-I).ResultsAnalgesia was best in group A, and similar in groups B and C; 2 cases of pruritus were noted in group C. The VAS-I scores were <3 across all 3 patient groups.ConclusionEpidural analgesia is an efficacious and reliable technique. The combination of 0.2% ropivacaine and 0.75 microg/ml(-1) sufentanil was found to be the optimum choice between analgesic efficacy and minor side effects, which correlated with the higher dose of sufentanil given to group C.

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