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Effects of hyperbaric spinal ropivacaine for caesarean section: with or without fentanyl

Published online by Cambridge University Press:  02 June 2005

S. Sanli ,
A. Yegin ,
N. Kayacan ,
M. Yilmaz ,
N. Coskunfirat  and
B. Karsli
S. Sanli
Affiliation:
Akdeniz University, Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
A. Yegin
Affiliation:
Akdeniz University, Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
N. Kayacan
Affiliation:
Akdeniz University, Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
M. Yilmaz
Affiliation:
Akdeniz University, Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
N. Coskunfirat
Affiliation:
Akdeniz University, Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
B. Karsli
Affiliation:
Akdeniz University, Faculty of Medicine, Department of Anaesthesiology, Antalya, Turkey
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Extract

Summary

Background and objective: Adding various opioids to the local anaesthetic solution administrated intrathecally improves the analgesic potency of spinal analgesia. The purpose of this study was to evaluate the efficacy and safety of intrathecal fentanyl 10 μg added to 15 mg hyperbaric ropivacaine in patients undergoing caesarean section under spinal anaesthesia.

Methods: Thirty-seven healthy, full-term parturients were randomly assigned into two groups: Group S (saline group, n = 17) received 15 mg hyperbaric ropivacaine in 2.5 mL + 0.5 mL saline; Group F (fentanyl group, n = 20) received 15 mg hyperbaric ropivacaine in 2.5 mL + 10 μg fentanyl in 0.5 mL, intrathecally. Characteristics of spinal block, intraoperative quality of spinal anaesthesia, time to first feeling of pain (complete analgesia), time to first request of analgesics postoperatively (effective analgesia), side-effects and fetal outcomes were evaluated.

Results: Regression of sensory block to L5 was significantly prolonged in the fentanyl group compared with the saline group (P = 0.001). Time to the first feeling of pain (130.6 ± 15.8 min vs. 154.3 ± 31.1 min; P = 0.008) and the first analgesic requirement (161.2 ± 32.6 min vs. 213.0 ± 29.3 min; P < 0.001) were significantly shorter in the saline group compared with the fentanyl group. Side-effects, umbilical arterial and venous blood gases did not differ between the groups. Apgar scores were similar in both groups and no infants had an Apgar score ≤7 at 5 min.

Conclusions: The addition of fentanyl 10 μg, to hyperbaric ropivacaine 15 mg, for spinal anaesthesia increased the duration of analgesia in the early postoperative period in patients undergoing caesarean delivery.

Keywords

ANAESTHESIA OBSTETRICALCAESAREAN SECTION, anaesthesiaANAESTHESIA SPINALANAESTHETICS LOCAL, ropivacaine, ANALGESICS OPIOID, fentanyl
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 6 , June 2005 , pp. 457 - 461
Copyright
© 2005 European Society of Anaesthesiology

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References

Soni AK, Miller CG, Pratt SD, Hess PE, Oriol NE, Sarna MC. Low dose intrathecal ropivacaine with or without sufentanil provides effective analgesia and does not impair motor strength during labour: a pilot study. Can J Anaesth 2001; 48: 677–680.Google Scholar
Khaw KS, Ngan Kee WD, Wong M, Ng F, Lee A. Spinal ropivacaine for cesarean delivery: a comparison of hyperbaric and plain solutions. Anesth Analg 2002; 94: 680–685.Google Scholar
Van Kleef JW, Veering BT, Burm AG. Spinal anesthesia with ropivacaine: a double-blind study on the efficacy and safety of 0.5% and 0.75% solutions in patients undergoing minor lower limb surgery. Anesth Analg 1994; 78: 1125–1130.Google Scholar
Yegin A, Sanli S, Hadimioglu N, Akbas M, Karsli B. Intrathecal fentanyl added to hyperbaric ropivacaine for transurethral resection of the prostate. Acta Anaesthesiol Scand 2005; 49: 401–405.Google Scholar
Whiteside JB, Burke D, Wildsmith JA. Spinal anaesthesia with ropivacaine 5 mg ml−1 in glucose 10 mg ml−1 or 50 mg ml−1. Br J Anaesth 2001; 86: 241–244.Google Scholar
Gautier PE, De Kock M, Van Steenberge A, et al. Intrathecal ropivacaine for ambulatory surgery: a comparison between intrathecal bupivacaine and ropivacaine for knee surgery. Anesthesiology 1999; 91: 1239–1245.Google Scholar
McClellan KJ, Faulds D. Ropivacaine. An update of its use in regional anesthesia. Drugs 2000; 60: 1065–1093.Google Scholar
Moller IW, Fernandes A, Edstrom HH. Subarachnoid anaesthesia with 0.5% bupivacaine: effects of density. Br J Anaesth 1984; 56: 1191–1195.Google Scholar
Chambers WA, Edstrom HH, Scott DB. Effect of baricity on spinal anaesthesia with bupivacaine. Br J Anaesth 1981; 53: 279–282.Google Scholar
Phelan DM, MacEvilly M. A comparison of hyper- and isobaric solutions of bupivacaine for subarachnoid block. Anaesth Intens Care 1984; 12: 101–107.Google Scholar
Brown DT, Wildsmith JA, Covino BG, Scott DB. Effect of baricity on spinal anaesthesia with amethocaine. Br J Anaesth 1980; 52: 589–596.Google Scholar
Bannister J, McClure JH, Wildsmith JA. Effect of glucose concentration on the intrathecal spread of 0.5% bupivacaine. Br J Anaesth 1990; 64: 232–234.Google Scholar
Dahlgren G, Hultstrand C, Jakobsson J, Norman M, Eriksson EW, Martin H. Intrathecal sufentanil, fentanyl, or placebo added to bupivacaine for cesarean section. Anesth Analg 1997; 85: 1288–1293.Google Scholar
Chung CJ, Yun SH, Hwang GB, Park JS, Chin YJ. Intrathecal fentanyl added to hyperbaric ropivacaine for cesarean delivery. Reg Anesth Pain Med 2002; 27: 600–603.Google Scholar
Chung CJ, Choi SR, Yeo KH, Park HS, Lee SI, Chin YJ. Hyperbaric spinal ropivacaine for cesarean delivery: a comparison to hyperbaric bupivacaine. Anesth Analg 2001; 93: 157–161.Google Scholar
Sarvela PJ, Halonen PM, Kortilla KT. Comparison of 9 mg of intrathecal plain and hyperbaric bupivacaine both with fentanyl for cesarean delivery. Anesth Analg 1999; 89: 1257–1262.Google Scholar
Liu S, Chiu AA, Carpenter RL, et al. Fentanyl prolongs lidocaine spinal anesthesia without prolonging recovery. Anesth Analg 1995; 80: 730–734.Google Scholar
Liu SS. Optimizing spinal anesthesia for ambulatory surgery. Reg Anesth 1997; 22: 500–510.Google Scholar
Ben-David B, Solomon E, Levin H, Admoni H, Goldik Z. Intrathecal fentanyl with small-dose dilute bupivacaine: better analgesia without prolonging recovery. Anesth Analg 1997; 85: 560–565.Google Scholar
Goel S, Bhardwaj N, Grover VK. Intrathecal fentanyl added to intrathecal bupivacaine for day case surgery: a randomised study. Eur J Anaesth 2003; 20: 294–297.Google Scholar
Belzarena SD. Clinical effects of intrathecally administered fentanyl in patients undergoing cesarean section. Anesth Analg 1992; 74: 653–657.Google Scholar
Choi DH, Ahn HJ, Kim MH. Bupivacaine – sparing effect of fentanyl in spinal anesthesia for cesarean delivery. Reg Anesth Pain Med 2000; 25: 240–245.Google Scholar
Stocks GM, Hallworth SP, Fernando R, England AJ, Columb MO, Lyons G. Minimum local analgesic dose of intrathecal bupivacaine in labor and the effect of intrathecal fentanyl. Anesthesiology 2001; 94: 593–598.Google Scholar
Khaw KS, Ngan Kee WD, Wong EL, Liu JY, Chung R. Spinal ropivacaine for cesarean section: a dose-finding study. Anesthesiology 2001; 95: 1346–1350.Google Scholar
Varrassi G, Celleno D, Capogna G, et al. Ventilatory effects of subarachnoid fentanyl in the elderly. Anaesthesia 1992; 47: 558–562.Google Scholar
Shende D, Cooper GM, Bowden MI. The influence of intrathecal fentanyl on the characteristics of subarachnoid block for caesarean section. Anaesthesia 1998; 53: 706–710.Google Scholar