[Optimal dose of fentanyl for postoperative epidural analgesia after cesarean section].
BACKGROUND
The aim of this study was to investigate which dose of fentanyl in ropivacaine for epidural anesthesia will provide effective analgesia with minimal side effects after cesarean section (CS).


METHODS
Fifty eight patients scheduled for CS were randomly allocated to two groups according to fentanyl dose in epidural analgesia: group F1 (11 microg x hr(-1); n=30) or group F 2 (21 microg x hr(-1); n= 28). Ropivacaine 0.2% 100 ml with fentanyl 400 or 800 microg was administered into the epidural space in the groups F1 and F 2, respectively. Pain scores (visual analogue scale: VAS) with cough or movement, Bromage score, incidence of diclofenac or pentazocine administration, satisfaction score (VAS) and side effects (nausea, vomiting and pruritus) were recorded after CS.


RESULTS
Pain scores with cough or movement were significantly lower in the group F 2 than the group F 1 at twelve and twenty-four hours after CS. Bromage score at twelve hours was lower in the group F 2 than the group F 1. The incidences of side effects were similar between the two groups. Satisfaction score was significantly higher in the group F 2 than the group F 1.


CONCLUSIONS
We conclude that continuous epidural administration of fentanyl 21 microg x hr(-1) with ropivacaine provides the optimum balance between pain relief and side effects compared with fentanyl 11 microg x hr(-1) with ropivacaine after CS.
Shirasaka
Tetsuro
T
Department of Anesthesiology, Faculty of Medicine, University of Miyazaki, Miyazaki.
Yonaha
Tetsu
T
Ookubo
Shigeaki
S
Nishimura
Emi
E
Kashiwada
Masatoshi
M
Takasaki
Mayumi
M
D000328:Adult; D000577:Amides / Q000008:administration & dosage; D015360:Analgesia, Epidural / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002585:Cesarean Section; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011247:Pregnancy; D000077212:Ropivacaine
D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000077212:Ropivacaine; D005283:Fentanyl