The effect of intrathecal fentanyl added to hyperbaric bupivacaine on maternal respiratory function during Cesarean section.
BACKGROUND
Subarachnoid blockade with local anesthetics induces respiratory depression. Although the addition of fentanyl to bupivacaine has become popular in subarachnoid blockade for Cesarean section, there is no information on the effect of intrathecal fentanyl on maternal spirometric respiratory function in parturients undergoing Cesarean section.


METHODS
We tested the effect of the addition of intrathecal fentanyl to hyperbaric bupivacaine on maternal spirometric performance in 40 consenting parturients undergoing Cesarean section. The parturients were randomized into two groups: those receiving 2.0 ml of hyperbaric bupivacaine 0.5% and 0.4 ml of saline intrathecally and those receiving 2.0 ml of hyperbaric bupivacaine and 0.4 ml of fentanyl (20 microg) intrathecally. We performed spirometry on arriving at the operation room and 15 min after subarachnoid blockade.


RESULTS
Subarachnoid blockade with bupivacaine significantly decreased the peak expiratory flow rate, but did not induce significant changes in vital capacity and forced vital capacity. The addition of intrathecal fentanyl to bupivacaine improved the quality of subarachnoid blockade, but did not lead to a deterioration in respiratory function compared with intrathecal bupivacaine alone.


CONCLUSIONS
The addition of intrathecal fentanyl to hyperbaric bupivacaine did not lead to a deterioration in maternal spirometric respiratory function in parturients undergoing Cesarean section.
Department of Anesthesiology, Ehime Rosai Hospital, Niihama City, Ehime, Japan. arainon@aichi-med-u.ac.jp
Y-C P
YC
Arai
J
J
Ogata
K
K
Fukunaga
A
A
Shimazu
A
A
Fujioka
T
T
Uchida
D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D002045:Bupivacaine / Q000008:administration & dosage*; D002585:Cesarean Section; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D011247:Pregnancy; D012119:Respiration / Q000187:drug effects*; D014797:Vital Capacity / Q000187:drug effects
D005283:Fentanyl; D002045:Bupivacaine