Adding sufentanil to ropivacaine in pediatric brachial plexus block fails to improve analgesi a : A randomised controlled trial

Abstract Background Most studies had used sufentanil and ropivacaine for intrathecal anesthesia in adults or children，but few studies had used sufentanil and ropivacaine for peripheral nerve block, especially in children. Brachial plexus block was one of the most commonly used nerve block methods in children. Therefore, the purpose of this study was to investigate whether 0.1µg/kg sufentanil combined with 0.25% ropivacaine can improve analgesia and prolong analgesia in children compared with ropivacaine alone.Methods 80 children, ASA I, aged 5-10 years old, undergoing upper limb surgery, were randomly divided into two groups: RS group(0.25% ropivacaine combined with 0.1µg/kg sufentanil) and R group (0.25% ropivacaine alone). The dosage of 0.25% ropivacaine administered in each group was 0.5ml/kg. After general anesthesia, all children underwent ultrasound-guided brachial plexus block and were performed by the same experienced anesthetist. The primary outcome measures were the 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, the incidence of postoperative agitation, the postoperative awake time and the duration of stay in PACU. Results The FLACC scores at 2, 4 and 6 hours after surgery and the duration of analgesia showed no statistically significant difference. There were no statistically significant differences in the changes in vital signs during surgery in each group. The incidence of postoperative agitation was significantly lower in RS group than R group(20% vs 45%, P<0.05). Comparison of the postoperative awake time and the duration of stay in PACU showed that there were no significant differences respectively.Conclusion Compared with 0.25% ropivacaine alone, 0.1µg/kg sufentanil combined with 0.25% ropivacaine for pediatric brachial plexus block did not improve analgesia and prolong analgesia, but reduced postoperative agitation in the children.Trial RegistrationRegistration of Chinese Clinical Trial Registry(Date:19/04/2020, Number:ChiCTR2000032071).