اثر سوفنتانیل داخل نخاعی بر عوارض همودینامیک بی حسی داخل نخاعی با لیدوکائین %5 در عمل جراحی سزارین

Background and Aim: Spinal anesthesia is the preferred method for cesarian section -because of minimal maternal and neonatal complications and low cost. Intrathecal sufentanil is used for augmentation of analgesic effect in spinal anesthesia. The aim of this study was to evaluate the effect of intrathecal sufentanil on hemodynamic measurements and other complications. Materials and Methods: This randomized double-blinded clinical trial was done in Rasool-e-Akram hospital in Tehran and Niknafas maternity hospital in Rafsanjan on 100 full term pregnant women who were candidate for cesarean section. Lidocaine 5% was used for spinal anesthesia and participants were indicated to receive intrathecal administration of 5 mg sufentanil or placebo. For 50 patients, in addition to lidocaine, 5 micrograms (1 mL) intrathecal sufentanil was administered (case group). In the control group, instead of sufentanil, 1mL of normal saline was injected. The obtained data was analysed by SPSS using fisher exact tests, and independent t-tests at significant level P≤0.05. Results: Decreased blood pressure of more than 10% in the case and control groups were observed in 32.6% (16 individuals) and 67.4% (31 cases), respectively. Decreased heart rate of lower than 10% were measured in 40.8% (20 cases) and 91.3% (42 cases) of the case and control groups, respectively. Both of the above complications were significantly lower in the case group compared with control group (P<0.0001). Regarding other complications such as nausea, vomiting, respiratory depression, and neonatal apgar, no significant differences were noted between the two groups. However, itching was observed in 11 patients (22%) of the case group but not in the controls. Conclusion: Addition of 5 microgram sufentanil to lidocaine 5% for spinal anesthesia in cesarean section improved hemodynamic stability without causing important complication. The only noticeable side effect of sufentanil was mild pruritus.