Comparison of different fentanyl doses in spinal anesthesia for caesarian delivery

Year 2020, Volume: 17 Issue: 1, 258 - 261, 31.03.2020

Fatma Kavak Akelma , Zahide Özlem Ulubay , Sengül Özmert , Betül Güven Aytaç , Galip Özmert

Abstract

INTRODUCTION
We aimed to compare the clinical efficacy and characteristics of bupivacaine spinal block when combined with either 10 or 25 mcg fentanyl in spinal anesthesia for Cesarean delivery. We also sought to evaluate its effects on maternal and neonatal hemodynamics.
MATERIAL AND METHODS
American Society of Anesthesiologists (ASA) Score I-II pregnant women aged 18-45 years who received spinal anesthesia for elective Cesarean section were included in the study. Age, weight, height, weeks of gestation at delivery. Patients were divided into three groups: Patients who received hyperbaric bupivacaine alone were classified as Group I, those who received hyperbaric bupivacaine plus 10 mcg fentanyl were classified as Group II and those who received hyperbaric bupivacaine plus 25 mcg fentanyl were classified as Group III. Block characteristics, as well as hemodynamic data, were retrieved from records. Additionally, heart rate, SpO2 readings at 5- and 10- minute and 1- and 5- minute Apgar scores of the newborn were noted.
RESULTS
Demographic properties were similar among the three groups. Mean time to onset of sensory block at T10 dermatome and mean time to Modified Bromage scale 3 was significantly shorter in Group III compared to the other two groups (p<0,05). The first analgesic requirement time was found to be longer in Group II and III compared to Group I (p= 0,05). SBP and DBP values at 3-minute were significantly decreased in all three groups (p<0,05). The difference in-between the three groups, however, was not significant. One- and 5-minute Apgar scores were similar among groups. 5- and 10-minute heart rates and saturation rates of the newborns did not differ among groups. The incidence of postoperative headache, pruritus, nausea, vomiting and urinary retention was also similar among the groups.

CONCLUSION
We recommend the use of intrathecal fentanyl because it shortens the onset time of anesthesia, increases the quality of intraoperative analgesia, prolongs the duration of sensorial block and delays the onset of postoperative pain.

Keywords

Spinal anesthesia, fentanyl, cesarean delivery, bupivacaine

Thanks

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