[The effect of intrathecal fentanyl added to hyperbaric bupivacaine for caesarean section].
BACKGROUND
Management of cesarean section with spinal anesthesia is often accompanied with intraoperative nausea and pain. In a randomized controlled study, we explored the effect of intrathecal fentanyl on the characteristics of subarachnoid block in patients undergoing cesarean section.


METHODS
Twenty-four healthy parturients scheduled for elective Cesarean section were allocated to receive either fentanyl 0.3 ml (15 micrograms) or 0.9% saline 0.3 ml added to 0.5% hyperbaric bupivacaine 2.0 ml given intrathecally in the right decubitus position (n = 12 in each group). Level of sensory blockade was evaluated with cold test and intraoperative use of antiemetics and analgesics was recorded.


RESULTS
The maximum level of sensory blockade was significantly higher in the fentanyl group as compared with the control group (P = 0.019). Use of intraoperative antiemetics was significantly less often in the fentanyl group (P = 0.007). The required amount of intraoperative analgesics was smaller in the fentanyl group, although the difference was not significant (P = 0.11). No remarkable side effects, such as respiratory depression and hypoxia were observed. Apgar scores in the newborn were similar.


CONCLUSIONS
Addition of intrathecal fentanyl to hyperbaric bupivacaine in parturients undergoing cesarean section improved quality of anesthesia without producing significant side effects.
Department of Anesthesiology, Tokyo University School of Medicine, Tokyo 113-8655.
Mizuki
M
Obara
Shigehito
S
Sawamura
Yoshiaki
Y
Satoh
Mieko
M
Chinzei
Hiroshi
H
Sekiyama
Hisayoshi
H
Tamai
Hirotoshi
H
Yamamoto
Kazuo
K
Hanaoka
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000770:Anesthesia, Endotracheal; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local; D002045:Bupivacaine; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control*; D009325:Nausea / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D016896:Treatment Outcome
D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine