The effects of fentanil addition to the bupivacaine intrathecally administered for the cesarean operations [Sezaryenlerde İntratekal Bupivakain'e Fentanil İlavesinin Etkileri]

Abstract

In this study, we aimed to compare the intraoperative and early postoperative analgesia and complications of hyperbaric bupivacaine alone and hyperbaric bupivacaine plus fentanyl for cesarean sections. After the approval of the ethical committee and the patients, 45 ASA I-II patients were divided into three groups consisting of 15 patients. In all groups, a total drug volume of 2.4 ml was given intrathecally. Group I was given 10 mg 0.5 % hyperbaric bupivacaine, Group II was given 10 mg 0.5 % hyperbaric bupivacaine plus 20 ?g fentanyl, Group III was given 5 mg 0.5 % hyperbaric bupivacaine plus 20 ?g fentanyl. Blood pressure, heart rate, respiratory rate, SpO2, sensorial and motor block levels, peroperative pain, muscle relaxation and side effects were recorded. The newborns were evaluated according to Apgar score and umblical cord blood gases. Morphine sulphate iv was used for postoperative patient controlled analgesia. In all groups, sensorial block and anesthesia were satisfactory. The intraoperative analgesia was lower in the fentanyl groups. Group II had a longer postoperative analgesia duration (p<0.05). Group III had a lower motor blockade than the others and hypotension requiring ephedrine was less (p<0.05). There were no differences regarding postoperative morphine consumption and no life threatening side effects were observed. Itching was observed in the fentanyl groups. The newborns' evaluations were normal in all groups. To sum up, in cesarean operations the addition of 20 ?g fentanyl to 10 mg hyperbaric bupivacaine may improve anesthesia quality and provide longer postoperative analgesia. It was concluded that the addition of 20 ?g fentanyl to 5 mg hyperbaric bupivacaine provides lower level motor blockade and decreases the incidence of hypotension.