title: A comparison of intrathecal fentanyl and diamorphine as adjuncts in spinal anaesthesia for Caesarean section.
abstract: This randomised controlled trial examines the effects of fentanyl and diamorphine, alone and in combination, as adjuncts to spinal anaesthesia for Caesarean section. Ninety-nine women undergoing elective Caesarean section with spinal anaesthesia using 0.5% hyperbaric bupivacaine were randomly allocated to receive fentanyl 15 microg (F), diamorphine 0.25 mg (D), or fentanyl 15 microg plus diamorphine 0.25 mg (FD), intrathecally. All women received morphine via a patient controlled analgesia system after surgery. There was no significant difference between the groups in time to achieve a block, discomfort, ephedrine use, nausea and vomiting, pruritus and sedation during surgery. Significant differences were observed in morphine consumption 4, 8, 12 and 24 h after surgery between both F and D groups, and F and FD groups, and also at 2 h between F and FD groups. There was a significant difference in pruritus at 4 h between the F and FD group. Our results suggest that diamorphine alone provides optimum benefits during and after surgery, when used in combination with hyperbaric bupivacaine for Caesarean section.
authors.affiliation: Intensive Care, St George Hospital, Belgrave St, Kogarah, Sydney, NSW 2217, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Lane
authors.forename: P
authors.initials: P
authors.lastname: Evans
authors.forename: Z
authors.initials: Z
authors.lastname: Arfeen
authors.forename: U
authors.initials: U
authors.lastname: Misra
mesh_terms: D000759:Adjuvants, Anesthesia; D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local; D002045:Bupivacaine; D002585:Cesarean Section; D004334:Drug Administration Schedule; D005260:Female; D005283:Fentanyl; D003932:Heroin; D006801:Humans; D009020:Morphine / Q000008:administration & dosage; D010149:Postoperative Pain / Q000517:prevention & control; D011247:Pregnancy
chemical_list: D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D003932:Heroin; D009020:Morphine; D005283:Fentanyl; D002045:Bupivacaine