Anestesia e Pesquisa Clínica
Acesso livre

Abstrato

Adding Sufentanil to Ropivacaine in Pediatric Brachial Plexus Block Fails to Improve Analgesia: A Randomized Controlled Trial

Yang Nan*, Jia Lou, Li-qiong Chen, Chun-chun Zhu，Xing-wang Li1, Jun Li1

Background: Most studies have used sufentanil and ropivacaine for intrathecal anesthesia in adults or children, but few studies have used sufentanil and ropivacaine for peripheral nerve blocks, especially in children. The brachial plexus block is one of the most commonly used nerve block methods in children. Therefore, the purpose of this study was to investigate whether 0.1 µg/kg sufentanil combined with 0.25% ropivacaine can improve and prolong analgesia in children compared with ropivacaine alone.

Method: Eighty children, aged 5-10 years, undergoing upper limb surgery were randomly divided into two groups: the RS group (0.25% ropivacaine combined with 0.1 µg/kg sufentanil) and the R group (0.25% ropivacaine alone). The dosage of 0.25% ropivacaine administered to each group was 0.5 ml/kg. After general anesthesia, all children underwent ultrasound-guided brachial plexus block, which was performed by the same experienced anesthetist. The primary outcome measures were the Face, Legs, Activity, and Cry, Consolability Scale (FLACC) score at 2, 4, and 6 h after surgery and the duration of analgesia in each group. Secondary outcome measures were the changes in vital signs during surgery in each group, incidence of postoperative agitation, postoperative awake time, and duration of stay in the Post-Anesthesia Care Unit (PACU).

Results: The FLACC scores at 2, 4, and 6 hours after surgery and the duration of analgesia showed no statistically significant differences. There were no statistically significant differences in the changes in the vital signs during surgery between the groups. The incidence of postoperative agitation was significantly lower in the RS group than that in the R group (20% vs. 45%, P<0.05). A comparison of the postoperative awake time and duration of stay in the PACU showed no significant differences.

Conclusion: Compared with 0.25% ropivacaine alone, 0.1 µg/kg sufentanil combined with 0.25% ropivacaine for pediatric brachial plexus block did not improve analgesia or prolong analgesia, but it reduced postoperative agitation in children. The trial was registered with the Chinese Clinical Trial Registry (number: ChiCTR2000032071).