title: Comparative analgesic enhancement of alfentanil, fentanyl, and sufentanil to spinal tetracaine anesthesia for cesarean delivery.
abstract: Clinical investigations have shown that intrathecal local anesthetic combined with alfentanil, fentanyl, or sufentanil results in a synergetic interaction that improves perioperative analgesia. However, there are as yet few studies designed to compare equal potency dose of these three 4-anilinopiperidine analogues. This prospective study is an attempt to study the comparative analgesic properties of these three drugs. 156 parturients who had consented to spinal anesthesia for cesarean delivery, were anesthetized with 12 mg of tetracaine which was combined with various doses of these three opioids. The addition of these intrathecal opioids significantly improved analgesia. Intra-operatively, 26% of the control group had insufficient analgesia while all patients in the sufentanil or fentanyl groups had sufficient analgesia without needing any analgesic supplementation. Postoperatively 10 micrograms of sufentanil delayed the onset of any postoperative pain from 106 to 286 min. Side effects such as pruritus, respiratory depression, nausea, and vomiting were not different from those of the control group. This study indicates that 10ug sufentanil appears to be better than alfentanil or fentanyl in improving intra- and postoperative analgesia in parturient undergoing hyperbaric tetracaine spinal anesthesia for cesarean section.
authors.affiliation: Department of Anesthesia, Mackay Memorial Hospital, Taitung, Taiwan, R.O.C.
authors.forename: M H
authors.initials: MH
authors.lastname: Pan
authors.forename: T T
authors.initials: TT
authors.lastname: Wei
authors.forename: B S
authors.initials: BS
authors.lastname: Shieh
mesh_terms: D000293:Adolescent; D000328:Adult; D015760:Alfentanil; D016362:Analgesia, Obstetrical; D000704:Analysis of Variance; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D002585:Cesarean Section; D016009:Chi-Square Distribution; D005260:Female; D005283:Fentanyl; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D017409:Sufentanil; D013748:Tetracaine
chemical_list: D013748:Tetracaine; D015760:Alfentanil; D017409:Sufentanil; D005283:Fentanyl