Beneficial effects of the addition of intrathecal fentanyl to bupivacaine for spinal anesthesia in cesarean section

Abstract

Background: The addition of fentanyl or epinephrine to bupivacaine enhances the quality of intraoperative spinal anesthesia during cesarean section. This study aimed to evaluate the beneficial effects of adding fentanyl or epinephrine to bupivacaine in spinal anesthesia solutions used for patients undergoing cesarean section. Methods: This retrospective study included 391 patients who underwent cesarean section under spinal anesthesia between March 2009 and February 2014. Parturients were categorized into group N (no addition; n = 103), group E (addition of epinephrine; n = 196), and group F (addition of fentanyl; n = 92). Perioperative hemodynamic changes, complications, sensory recovery times, Apgar scores, and cord blood pH were analyzed. Results: Nausea and vomiting occurred more frequently in group E than in the other two groups (P ＜ 0.001 and P = 0.027, respectively). The mean sensory recovery times to T10 level showed statistically significant intergroup differences (P ＜ 0.001). Group F showed the highest 1-min and 5-min Apgar scores, with statistically significant differences amongst the three groups (P = 0.007 and P ＜ 0.001, respectively). However, the blood gas analysis variables of the cord blood did not show significant differences. Conclusions: Addition of fentanyl to bupivacaine was related to a longer sensory recovery time than did the addition of nothing or epinephrine. Moreover, it had been associated with beneficial effects such as a reduction in complications following spinal anesthesia. (Anesth Pain Med 2017; 12: 233-239)

Evaluation of changes in anesthetic methods for cesarean delivery: an analysis for 5 years using the big data of the Korean Health Insurance Review and Assessment Service

“…Although there have been skeptical opinions about spinal anesthesia in the past, including reports of low cord pH in fetuses born from spinal anesthesia [ 6 – 8 ], several studies have been conducted on the treatment of post-spinal anesthesia hypotension ever since, and the complications of spinal anesthesia have gradually decreased [ 9 ]. Additionally, a previous study has identified the positive effect of administering intrathecal opioids for postoperative pain [ 10 , 11 ], with high satisfaction as parturients were able to ambulate faster after the operation when spinal anesthesia, rather than general anesthesia, was administered [ 12 ]. Spinal anesthesia is also more economically beneficial compared to epidural anesthesia [ 13 ].…”

Effect of Intrathecal Fentanyl on Shivering During Spinal Anesthesia

“…29 Whereas in another study incidence of pruritus was nil. 30 In another study by kuusniemi et al 31 , they observed that pruritus was the most common adverse effect, occurring in 22.5% of all patients after intrathecal fentanyl.…”