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Sufentanil for carboprost-induced adverse reactions during cesarean delivery under combined spinal-epidural anesthesia
, 2, 3, 45, 6, 4, 45, 1
Affiliations- Laboratory of Molecular Translational Medicine, Centre for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Clinical Research Center for Birth Defects of Sichuan Province, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, P.R. China, China
- The second Affiliated hospital of Zhejiang University School of medicine, Hangzhou, Zhejiang, P.R. China
- Department of Forensic Genetics, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, Sichuan, P.R. China
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
- Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu, P.R. China
- Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, P.R. China
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Abstract
Objectives: Carboprost plays an important role in managing refractory uterine atony and severe postpartum hemorrhage. However, it is associated with challenging adverse reactions. We aimed to evaluate the clinical effects of low dose sufentanil on the prevention of adverse events associated with carboprost during cesarean delivery.
Material and methods: Patients were randomly divided into two groups: a placebo control group (group C, n = 15) that received an intravenous infusion of 1 mL of normal saline 2 min before carboprost and a sufentanil group (group S, n = 15) that received 5 μg of sufentanil. The primary outcome was the incidence of nausea and vomiting following carboprost administration.
Results: The incidence of nausea, vomiting, and gastrointestinal discomfort was significantly lower in group S than in group C (p < 0.05).
Conclusions: The prophylactic use of low dose sufentanil reduces the incidence of gastrointestinal side effects caused by carboprost administration during cesarean section.
Abstract
Objectives: Carboprost plays an important role in managing refractory uterine atony and severe postpartum hemorrhage. However, it is associated with challenging adverse reactions. We aimed to evaluate the clinical effects of low dose sufentanil on the prevention of adverse events associated with carboprost during cesarean delivery.
Material and methods: Patients were randomly divided into two groups: a placebo control group (group C, n = 15) that received an intravenous infusion of 1 mL of normal saline 2 min before carboprost and a sufentanil group (group S, n = 15) that received 5 μg of sufentanil. The primary outcome was the incidence of nausea and vomiting following carboprost administration.
Results: The incidence of nausea, vomiting, and gastrointestinal discomfort was significantly lower in group S than in group C (p < 0.05).
Conclusions: The prophylactic use of low dose sufentanil reduces the incidence of gastrointestinal side effects caused by carboprost administration during cesarean section.
Keywords
cesarean delivery; sufentanil; opioids; carboprost; side effects; nausea and vomiting
About this articleTitle
Sufentanil for carboprost-induced adverse reactions during cesarean delivery under combined spinal-epidural anesthesia
Journal
Issue
Article type
Research paper
Pages
379-388
Published online
2022-04-13
Page views
2158
Article views/downloads
652
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(5):379-388.
Keywords
cesarean delivery
sufentanil
opioids
carboprost
side effects
nausea and vomiting
Authors
Qian Hu
Jin Guo
Peng Bai
Xue Xiao
Teng He
Pei Yang
Huafeng Li
Lin Zhang
References (35)- Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014; 2(6): e323–e333.
- Souza JP, Gülmezoglu AM, Vogel J, et al. Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study. Lancet. 2013; 381(9879): 1747–1755.
- Carroli G, Cuesta C, Abalos E, et al. Epidemiology of postpartum haemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol. 2008; 22(6): 999–1012.
- WHO. WHO Guidelines Approved by the Guidelines Review Committee. World Health Organization. Geneva, 2018.
- Rath W. Prevention of postpartum haemorrhage with the oxytocin analogue carbetocin. Eur J Obstet Gynecol Reprod Biol. 2009; 147(1): 15–20.
- Hayashi RH, Castillo MS, Noah ML, et al. Management of severe postpartum hemorrhage due to uterine atony using an analogue of prostaglandin F2 alpha. Obstet Gynecol. 1981; 58(4): 426–429.
- Bai J, Sun Q, Zhai H. A comparison of oxytocin and carboprost tromethamine in the prevention of postpartum hemorrhage in high-risk patients undergoing cesarean delivery. Exp Ther Med. 2014; 7(1): 46–50.
- Butwick AJ, Carvalho B, Blumenfeld YJ, et al. Second-line uterotonics and the risk of hemorrhage-related morbidity. Am J Obstet Gynecol. 2015; 212(5): 642.e1–642.e7.
- Vallera C, Choi LO, Cha CM, et al. Uterotonic Medications: Oxytocin, Methylergonovine, Carboprost, Misoprostol. Anesthesiol Clin. 2017; 35(2): 207–219.
- Buttino L, Garite TJ. The use of 15 methyl F2 alpha prostaglandin (Prostin 15M) for the control of postpartum hemorrhage. Am J Perinatol. 1986; 3(3): 241–243.
- Wei CN, Chang XY, Dong JH, et al. Remifentanil for carboprost-induced adverse reactions during cesarean delivery under combined spinal-epidural anesthesia. Front Pharmacol. 2020; 11: 980.
- Fruhwald S, Herk E, Petnehazy T, et al. Sufentanil potentiates the inhibitory effect of epinephrine on intestinal motility. Intensive Care Med. 2002; 28(1): 74–80.
- De Schepper HU, Cremonini F, Park MI, et al. Opioids and the gut: pharmacology and current clinical experience. Neurogastroenterol Motil. 2004; 16(4): 383–394.
- Baroffio M, Crimi E, Rehder K, et al. Effects of κ- and μ-opioid agonists on cholinergic neurotransmission and contraction in isolated bovine trachealis. Respir Physiol Neurobiol. 2013; 185(2): 281–286.
- Klein SM, Evans H, Nielsen KC, et al. Peripheral nerve block techniques for ambulatory surgery. Anesth Analg. 2005; 101(6): 1663–1676.
- Tarhan O, Canbay O, Celebi N, et al. Subhypnotic doses of midazolam prevent nausea and vomiting during spinal anesthesia for cesarean section. Minerva Anestesiol. 2007; 73(12): 629–633.
- Demirhan A, Tekelioglu YU, Akkaya A, et al. Antiemetic effects of dexamethasone and ondansetron combination during cesarean sections under spinal anaesthesia. Afr Health Sci. 2013; 13(2): 475–482.
- Heesen M, Carvalho B, Carvalho JCA, et al. International consensus statement on the use of uterotonic agents during caesarean section. Anaesthesia. 2019; 74(10): 1305–1319.
- Sunil Kumar KS, Shyam S, Batakurki P. Carboprost versus oxytocin for active management of third stage of labor: a prospective randomized control study. J Obstet Gynaecol India. 2016; 66(Suppl 1): 229–234.
- Dahlgren G, Hultstrand C, Jakobsson J, et al. Intrathecal sufentanil, fentanyl, or placebo added to bupivacaine for cesarean section. Anesth Analg. 1997; 85(6): 1288–1293.
- Thorén T, Tanghöj H, Mattwil M, et al. Epidural morphine delays gastric emptying and small intestinal transit in volunteers. Acta Anaesthesiol Scand. 1989; 33(2): 174–180.
- Porreca F, Ossipov MH. Nausea and vomiting side effects with opioid analgesics during treatment of chronic pain: mechanisms, implications, and management options. Pain Med. 2009; 10(4): 654–662.
- Chaney MA. Side effects of intrathecal and epidural opioids. Can J Anaesth. 1995; 42(10): 891–903.
- Balki M, Carvalho JCA. Intraoperative nausea and vomiting during cesarean section under regional anesthesia. Int J Obstet Anesth. 2005; 14(3): 230–241.
- Wilder-Smith CH, Hill L, Osler W, et al. Effect of tramadol and morphine on pain and gastrointestinal motor function in patients with chronic pancreatitis. Dig Dis Sci. 1999; 44(6): 1107–1116.
- Reichert J, Daughters R, Rivard R, et al. Peripheral and preemptive opioid antinociception in a mouse visceral pain model. Pain. 2001; 89(2): 221–227.
- Lampati L, Colantonio LB, Calderini E. Cardiac arrest during sulprostone administration — a case report. Acta Anaesthesiol Scand. 2013; 57(3): 395–397.
- Hankins G, Berryman GK, Scott RT, et al. Maternal arterial desaturation with 15-methyl prostaglandin F2 alpha for uterine atony. Obstetric Anesthesia Digest. 1989; 9(1): 16.
- Belvisi MG, Chung KF, Jackson DM, et al. Opioid modulation of non-cholinergic neural bronchoconstriction in guinea-pig in vivo. Br J Pharmacol. 1988; 95(2): 413–418.
- Zappi L, Nicosia F, Rocchi D, et al. Opioid agonists modulate release of neurotransmitters in bovine trachealis muscle. Anesthesiology. 1995; 83(3): 543–551.
- Yasuda I, Hirano T, Yusa T, et al. Tracheal constriction by morphine and by fentanyl in man. Anesthesiology. 1978; 49(2): 117–119.
- Segal BJ. Tracheal constriction of decreased lung-thorax compliance from opiates. Anesthesiology. 1979; 51(2): 183–184.
- Tosun M, Paul RJ, Rapoport RM. Intracellular Ca2+ elevation and contraction due to prostaglandin F2alpha in rat aorta. Eur J Pharmacol. 1997; 340(2-3): 203–208.
- Toppozada M, El-Bossaty M, El-Rahman HA, et al. Control of intractable atonic postpartum hemorrhage by 15-methyl prostaglandin F2 alpha. Obstet Gynecol. 1981; 58(3): 327–330.
- Laubie M, Schmitt H, Drouillat HM, et al. Central sites and mechanisms of the hypotensive and bradycardic effects of the narcotic analgesic agent fentanyl. Naunyn Schmiedebergs Arch Pharmacol . 1977; 296(3): 255–261.
