Perioperative Analgesia with Subarachnoid Fentanyl–Bupivacaine for Cesarean Delivery

Hunt, Catherine; Naulty, J. S.; Bader, Angela M.; Hauch, M A; Vartikar, Jasmine; Datta, Sanjay; Hertwig, L; Ostheimer, Gerard W.

doi:10.1097/00000542-198910000-00009

Cited by 257 publications

(180 citation statements)

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“…15 But the magnitude of BP fall and use of ephedrine is similar in both the groups. These results are comparable to the findings of Khan et al, Dixit et al, Shaik et al [16][17][18] There was no change in neonatal APGAR scores among the groups, which were similar with the observations made by Hunt et al and Shendi et al 19,20 In our study, we found that Buprenorphine produced prolonged analgesia without increase in the incidence of side effects, when compared to fentanyl.…”

Section: Discussionsupporting

confidence: 92%

A prospective randomised double blind study of the comparison of two opioids- fentanyl and buprenorphine – as adjuvant to spinal bupivacaine in caesarean sections

Sonya

Davies

2017

Int J Clin Trials

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Background: Opioids are first introduced as additives to spinal anaesthesia in 1979, with intrathecal morphine as forerunner. Neuraxial opioids when added to local anaesthetics prolong the duration of sensory block, improve quality of block and no unwanted sympathetic blockade leading to hypotension. This prospective randomized double blind study was undertaken to evaluate the duration of analgesia, sensory and motor blocking properties and side effects of two opioids – Fentanyl and Buprenorphine, when used as adjuvant to spinal Bupivacaine in caesarean section.Methods: Sixty patients between the age group 18-35 years belonging to ASA I and II posted for elective LSCS were randomly divided into two groups. Each group consisting of 30 patients , received either 1.8 ml 0.5% Bupivacaine with 25 mcg Fentanyl (group F) or 1.8 ml 0.5% Bupivacaine with 75 mcg buprenorphine (Group B). The onset, maximum level and duration of sensory and motor blockade and hemodynamic parameters were monitored.Results: Maximum height of sensory block was achieved faster in fentanyl group (i.e. 4.09±1.12 minutes compared to 4.56±1.21 minutes in buprenorphine group). Duration of analgesia was significantly prolonged in buprenorphine group. It was 317±54 minutes and 214±35 minutes respectively for buprenorphine and fentanyl groups.Conclusions: The study thus concluded that although fentanyl produce faster sensory block, duration of analgesia is longer with buprenorphine, and both the drugs do not cause significant side effects.

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Section: Discussionsupporting

confidence: 92%

A prospective randomised double blind study of the comparison of two opioids- fentanyl and buprenorphine – as adjuvant to spinal bupivacaine in caesarean sections

Sonya

Davies

2017

Int J Clin Trials

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“…Previous studies have shown that patients who had undergo cesarean section under spinal anesthesia, benefit from simultaneous administration of local anesthetics and opiates because of increased ease of surgery [22] , significant increase in duration of spinal anesthesia [23] and lesser need for sedatives and analgesia post operatively [24] . The findings of the present study confirm the results of other studies for example Shahriari et al [25] showed that adding 15 µg fentanyl to 80 mg lidocaine intrathecally increased the duration of anesthesia and quality of analgesia during spinal anesthesia in women who undergo cesarean section.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have demonstrated similar results. For example, some studies have shown that administration of 15 µg intrathecal fentanyl is not associated with respiratory depression [25,28,29] . Also this is in accordance with basic science investigations that postoperative pain relief stabilizes patient hemodynamic [30] .…”

Section: Discussionmentioning

confidence: 99%

“…Fentanyl is well known for its rapid onset and shorter duration of action following intratechal administration [12,13] . Small doses of fentanyl (10 -40 µg) administered directly into the cerebrospinal fluid has been found to be very effective in minimizing discomfort during cesarean delivery without increasing serious adverse effects [13][14][15][16][17] . Chow et al [18] showed that low dose intratechal fentanyl during transurethral resection of prostate (TURP) under spinal anesthesia was an effective method for decreasing both the incidence and intensity of shivering.…”

Section: Introductionmentioning

confidence: 99%

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The Efficacy of Three Different Doses of Intrathecal Fentanyl for Prevention of Shivering in Lower Limb Orthopedic Surgeries: A Randomized Double-Blind Controlled Trial

Safavi¹

2016

JAS

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. Shivering, along with pain, nausea and vomiting are cases of discomfort and dissatisfaction in patients undergoing spinal anesthesia [9] . The combination of lipophilic opioids with hyperbaric bupivacaine during spinal anesthesia provides reduced latency, longer duration of anesthesia and better quality of anesthesia [10] . Another known effect of intrathecal opioids is prevention and treatment AbstractBackground: Fentanyl has been used to prevent shivering in spinal anesthesia but still the effects of different doses have not been appropriately specified. The aim of this study was to assess the effect of 10 µg, 20 µg and 30 µg intrathecal fentanyl on prevention of shivering during and after lower limb orthopedic surgeries under spinal anesthesia. Materials and Methods:One hundred and twenty patients undergoing elective orthopedic surgery under spinal anesthesia were enrolled in this clinical trial. Subjects were randomly divided to four groups; Group P received 3 cc bupivacaine 0.5% plus normal saline intrathecally; Group A10 received 10 µg fentanyl plus 3 cc bupivacaine 0.5% intrathecally; Group B20 received 20 μg fentanyl plus 3 cc bupivacaine 0.5% intrathecally; and Group C30 received 30 μg fentanyl plus 3 cc bupivacaine 0.5% intrathecally. Shivering and the complications were recorded. Results: Shivering intensity was different between 4 groups (P = 0.014). There was no moderate, severe and very severe shivering seen in Group C30 but there was 16.7% moderate, 10% sever, and 6.7% very severe shivering seen in Group P. The total incidence of shivering after spinal anesthesia in Groups A10, Group B20, Group C30 and Group P were 53.5%, 26.7% , 6.7% and 63.3% respectively and there was statistically significant difference between 4 group in this regard (P < 0.001). Conclusion: Intrathecal bupivacaine combined with 30 μg fentanyl was superior to using 10 µg or 20 μg fentanyl for prevention of shivering during lower extremity orthopedic surgery.

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“…The addition of epinephrine to bupivacaine during spinal anesthesia for cesarean section has improved the quality of subarachnoid block [3]. Furthermore, the addition of opiates to bupivacaine given for the same surgical procedure improves operative analgesia and provides extended postoperative pain relief [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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

2017

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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)

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Perioperative Analgesia with Subarachnoid Fentanyl–Bupivacaine for Cesarean Delivery

Cited by 257 publications

References 0 publications

A prospective randomised double blind study of the comparison of two opioids- fentanyl and buprenorphine – as adjuvant to spinal bupivacaine in caesarean sections

A prospective randomised double blind study of the comparison of two opioids- fentanyl and buprenorphine – as adjuvant to spinal bupivacaine in caesarean sections

The Efficacy of Three Different Doses of Intrathecal Fentanyl for Prevention of Shivering in Lower Limb Orthopedic Surgeries: A Randomized Double-Blind Controlled Trial

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

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