title: [Assessment of the effect of intrathecal levobupivacaine combined with fentanyl or morphine on postoperative analgesia in patients undergoing cesarean section].
abstract: OBJECTIVE
  Our prospective, randomized, double-blind study aimed to detect the effect of intrathecal levobupivacaine combined with fentanyl or morphine on the postoperative analgesia in patients undergoing cesarean section.
  
  
  METHODS
  After approval by the hospital ethics committee and obtaining written informed consent, ASA I-II parturients undergoing elective cesarean section were enrolled in this study. None of the patients had any contraindication for spinal anesthesia or sensitivity to local anesthetics. Patients were randomly assigned in a double-blinded fashion to receive either intrathecal 10 mg 5% levobupivacaine + 0.1 mg morphine (Group M, n=30) or 10 mg 5% levobupivacaine + 20 mcg fentanyl (Group F, n=30). The onset of sensorial block and anesthesia, interval of effective analgesia until the first analgesic requirement, disappearance of motor block according to modified Bromage scale, duration of spinal analgesia, additional analgesic requirement, amount of additional analgesic, adverse effects, and postoperative patient satisfaction were recorded.
  
  
  RESULTS
  The additional analgesic requirement period was significantly longer in Group M than Group F (p<0.001). Intraoperative and postoperative complications were significantly higher in Group F than Group M (p<0.05). Intended, delivered and total analgesic amount values were significantly higher in Group F than Group M (p<0.001). Patient satisfaction and presentation elsewhere were significantly higher in Group M than Group F (p<0.01).
  
  
  CONCLUSIONS
  Despite more adverse effects, additional analgesic requirement is lower in Group M, and the long-term painless postoperative period accounts for the choice by mothers.
authors.affiliation: Department of Anesthesiology, İstanbul Education and Training Hospital, İstanbul, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Acar
authors.forename: Emine
authors.initials: E
authors.lastname: Ozyuvacı
authors.forename: Sule
authors.initials: S
authors.lastname: Vatansever
authors.forename: Naile
authors.initials: N
authors.lastname: Toprak
authors.forename: Onat
authors.initials: O
authors.lastname: Akyol
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000775:Anesthesia, Spinal / Q000592:standards*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007278:Injections, Spinal; D000077554:Levobupivacaine; D009020:Morphine / Q000008:administration & dosage; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D000077554:Levobupivacaine; D005283:Fentanyl; D002045:Bupivacaine