Effective volume of ropivacaine 0.1% plus sufentanil 0.3 μg·mL−1 for labour epidural analgesia initiation after dural puncture epidural technique: a biased-coin up-and-down sequential allocation study
Authors' conclusion
When using the DPE technique to initiate labour analgesia without a lidocaine test dose, the EV90 of ropivacaine 0.1% with sufentanil 0.3 μg·mL-1 was 18 mL (95% CI, 14 to 18).
Study context
- Population
- Nulliparous parturients, singleton pregnancy, ASA II–III, numerical rating scale (NRS) pain score > 5, cervical dilation < 5 cm, requesting labour analgesia; Dural puncture epidural (DPE) with 25 G Whitacre needle, no lidocaine test doseanalysed
- Participants
- 40 participants
- Comparison
- Initiation volumes of 12, 14, 16, 18 and 20 mL of ropivacaine 0.1% with sufentanil 0.3 μg·mL-1 after DPE
- 12n = 2
- 14n = 4
- 16n = 15
- 18n = 19
- Outcome
- Effective initiation volume in 90% of patients (EV90); effective analgesia = NRS ≤ 3 at 20 min
- Follow-up
- 20 min
Methodological detailsdose-finding, isotonic regression
- Dose-finding
- Isotonic regression
Main finding
As reported in the abstract
EV90
Estimated EV90 (isotonic regression), mL
18
95% CI 14 to 18
Further findings
Highest sensory block level ≥ T6
Safety
| Outcome | Values |
|---|---|
| HypotensionDid not require vasopressor treatment | 18 1 events |
Original publication
Effective volume of ropivacaine 0.1% plus sufentanil 0.3 μg·mL−1 for labour epidural analgesia initiation after dural puncture epidural technique: a biased-coin up-and-down sequential allocation study. Can J Anaesth. Published 19 August 2026. doi:10.
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