2002
DOI: 10.1097/00000539-200203000-00036
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Abstract: Fentanyl administered epidurally to parturients after cesarean delivery has a primarily spinal mechanism of action and this effect is enhanced by very small dose epidural bupivacaine and epinephrine.

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Cited by 28 publications
(28 citation statements)
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“…This synergistic argument is based upon work originally undertaken in animals [47, 48], together with subsequent studies conducted in human subjects [32–34, 49]. The human studies have tended to follow a similar research model in which the patient receives a background epidural infusion of local anaesthetic to which small patient‐controlled boluses of opioid are added, either epidurally or i.v.…”
Section: The Effect Of Administering Opioids Together With Local Anaementioning
confidence: 99%
“…This synergistic argument is based upon work originally undertaken in animals [47, 48], together with subsequent studies conducted in human subjects [32–34, 49]. The human studies have tended to follow a similar research model in which the patient receives a background epidural infusion of local anaesthetic to which small patient‐controlled boluses of opioid are added, either epidurally or i.v.…”
Section: The Effect Of Administering Opioids Together With Local Anaementioning
confidence: 99%
“…13,14 Continuous or patient-controlled epidural infusions of fentanyl, alone or in combination with a local anesthetic, provide good postoperative analgesia but indwelling epidural catheters used postoperatively have a 27% incidence of becoming dysfunctional, and an even higher incidence with active ambulation. 15,16 Furthermore, epidural infusion pumps can be cumbersome and may interfere with ambulation and with caring for the newborn, thus limiting their popularity and routine application. 15,16 Diamorphine, while clinically unavailable in the US for postoperative analgesia, is used intrathecally or epidurally in the UK for postoperative analgesia even more often than fentanyl or morphine.…”
mentioning
confidence: 99%
“…15,16 Furthermore, epidural infusion pumps can be cumbersome and may interfere with ambulation and with caring for the newborn, thus limiting their popularity and routine application. 15,16 Diamorphine, while clinically unavailable in the US for postoperative analgesia, is used intrathecally or epidurally in the UK for postoperative analgesia even more often than fentanyl or morphine. 17 Diamorphine has a higher lipid solubility than morphine, allowing more rapid uptake into neural tissue and a fast onset of analgesia.…”
mentioning
confidence: 99%
“…Human studies conducted in obstetric patients suggested that obstetric pain is particularly sensitive to lipophilic opioids and also small doses of these opioids administered intrathecally are as effective as small doses of local anesthetics, whereas spinal morphine is poorly analgesic [55]. Capogna et al established that the minimum analgesic dose of sufentanil and fentanyl was 21.1 mcg and 124.2 mcg respectively when these opioids are used as single epidural analgesic during the first stage of labour and that sufentanil was 5.9 times more potent than fentanyl.…”
Section: Opioidsmentioning
confidence: 99%