title: Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Randomized controlled study.
abstract: OBJECTIVE
  To evaluate the efficacy and side-effects of fentanyl and sufentanil combined with hyperbaric spinal bupivacaine in elective cesarean section.
  
  
  METHODS
  A prospective, randomized, double-blind study with 64 term parturients, distributed into 2 groups according to the opioid combined with hyperbaric bupivacaine 0.5% (10mg): GF - fentanyl (25 µg) and GS - sufentanil (5.0 µg). The latency and maximum sensory block level; degree and duration of motor block; duration and quality of analgesia; maternal-fetal repercussions were evaluated. This was an intention-to-treat analysis with a 5% significance level.
  
  
  RESULTS
  The latency period, maximum sensory block level, motor block degree and perioperative analgesia were similar in both groups. Motor block and analgesia had a longer duration in the sufentanil group. Maternal adverse effects and neonatal repercussions were similar. The incidence of hypotension was higher in the fentanyl group. In both groups, there was a predominance of patients who were awake and either calm or sleepy.
  
  
  CONCLUSIONS
  The addition of fentanyl and sufentanil to hyperbaric subarachnoid bupivacaine was shown to be effective for the performance of cesarean section, and safe for the mother and fetus. Analgesia was more prolonged with sufentanil.
authors.affiliation: Department of Anesthesiology, School of Medicine, Campinas State University, Campinas, SP, Brazil.
authors.forename: Angélica de Fátima de Assunção
authors.initials: Ade F
authors.lastname: Braga
authors.affiliation: Department of Anesthesiology, School of Medicine, UNICAMP, Campinas, SP, Brazil.
authors.forename: Franklin Sarmento da Silva
authors.initials: FS
authors.lastname: Braga
authors.affiliation: Department of Anesthesiology, School of Medicine, UNICAMP, Campinas, SP, Brazil.
authors.forename: Eunice Sizue
authors.initials: ES
authors.lastname: Hirata
authors.affiliation: Department of Anesthesiology, School of Medicine, UNICAMP, Campinas, SP, Brazil.
authors.forename: Rosa Inês Costa
authors.initials: RI
authors.lastname: Pereira
authors.affiliation: Department of Anesthesiology, School of Medicine, UNICAMP, Campinas, SP, Brazil.
authors.forename: José Aristeu
authors.initials: JA
authors.lastname: Frias
authors.affiliation: Department of Anesthesiology, School of Medicine, UNICAMP, Campinas, SP, Brazil.
authors.forename: Isadora Fregonese
authors.initials: IF
authors.lastname: Antunes
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D000704:Analysis of Variance; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects; D002585:Cesarean Section / Q000379:methods*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D061646:Operative Time; D011247:Pregnancy; D011446:Prospective Studies; D015203:Reproducibility of Results; D017409:Sufentanil / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D004338:Drug Combinations; D017409:Sufentanil; D005283:Fentanyl; D002045:Bupivacaine