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  • Title: Sparing effects of sufentanil on epidural ropivacaine in elderly patients undergoing transurethral resection of prostate surgery.
    Author: Li H, Li Y, He R.
    Journal: Yonsei Med J; 2015 May; 56(3):832-7. PubMed ID: 25837193.
    Abstract:
    PURPOSE: This study examined the sparing effect of sufentanil on the median effective concentration (EC₅₀) of epidural ropivacaine in elderly patients undergoing elective transurethral resection of prostate (TURP). MATERIALS AND METHODS: This was a prospective randomized double-blind dose-response study. Fifty eight elderly patients with American Society of Anesthesiologists physical status I-II who were scheduled for TURP surgery under epidural anesthesia were randomly allocated to a group receiving 15 mL of ropivacaine (group R) or a group receiving ropivacaine plus 5 μg of sufentanil (group RS). The concentration of ropivacaine was determined by a Dixon's up-and-down sequential allocation. The first participant received 0.3% of ropivacaine in both groups and subsequent concentrations were determined by the response of the previous patient in the same group. The EC₅₀ of epidural ropivacaine was analyzed using the Dixon and Massey method. RESULTS: The EC₅₀ of ropivacaine during TURP surgery was 0.186% (95% confidence interval, 0.173-0.200%) in group R, and 0.136% (95% confidence interval, 0.127-0.144%) in group RS (p<0.01). No differences in Bromage scale of motor block examination and the onset time of sensory block were observed. CONCLUSION: Administration of 5 μg of epidural sufentanil caused a 37% reduction in the EC₅₀ of epidural ropivacaine in elderly patients who underwent TURP surgery. Thus, sufentanil addition during surgery of TURP can decrease the dose of ropivacaine anesthesia required.
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