Abstract
A prospective, randomized, double-blind study was performed to compare the analgesic efficacy and side effects of epidural fentanyl, 25 pg vs 50 pg, when used to supplement epidural anaesthesia for elective Caesarean section. Fifty ASA I and II patients were randomized into two groups: Group I (n =24) received 25 pg and Group II (n = 26) received 50 pg of epidural fentanyl after the epidural test dose. No differences between the two groups were found on any measures of intraoperative pain, nausea, drowsiness, respiratory depression, hypotension, pruritus and neonatal outcome. The low levels of pain experienced by patients indicates that doses higher than 50 μg of epidural fentanyl are usually unnecessary for optimal analgesia.
Résumé
Une étude prospective en double-aveugle et randomisée a été conduite pour comparer l’efficacité analgésique et les effets secondaires du fentanyl en péridurale, 25 μg vs 50 μg. Le fentanyl est utilisé comme complément d’une anesthésie péridurale pour césarienne élective. Cinquante patientes ASA I and II ont été réparties de façon randomisée en deux groupes: le groupe I (n = 24) a reçu 25 pg de fentanyl et le groupe II (n = 26) 50 pg de fentanyl, injecté en péridurale après la dose test dans les deux groupes. Aucune différence entre les deux groupes n’a pu être mise en évidence concernant la douleur péri-opératoire, les nausées, la somnolence, la dépression respiratoire, l’hypotension, le prurit et les scores néonataux. Par ailleurs, les douleurs ressenties par les patientes étaient de faible importance, ceci montre que des doses supérieures à 50 μg de fentanyl sont le plus souvent non nécessaires pour l’obtention d’une analgésie optimale.
Article PDF
Similar content being viewed by others
References
Gaffud MP, Bansal P, Lawton C, Velasquez N, Watson WA. Surgical analgesia for cesarean delivery with epidural bupivacaine and fentanyl. Anesthesiology 1986; 65: 331–4.
Paech MJ, Westmore MD, Speirs HM. A double-blind comparison of epidural bupivacaine and bupivacaine-fentanyl for Caesarean section. Anaesth Intensive Care 1990; 18: 22–30.
King MJ, Bowden MI, Cooper GM. Epidural fentanyl and 0.5% bupivacaine for elective Caesarean section. Anaesthesia 1990; 45: 285–8.
Tessler MJ, Biehl DR, Naughler MA. Caesarean section with epidural carbonated lidocaine and fentanyl. Can J Anaesth 1988; 35: S110–1.
Preston PG, Rosen MA, Hughes SC, et al. Epidural anesthesia with fentanyl and lidocaine for cesarean section: maternal effects and neonatal outcome. Anesthesiology 1988; 68: 938–43.
Noble DW, Morrison LM, Brockway MS, McClure JH. Adrenaline, fentanyl or adrenaline and fentanyl as adjuncts to bupivacaine for extradural anaesthesia in elective Caesarean section. Br J Anaesth 1991; 66: 645–50.
Naulty JS, Datta S, Ostheimer G, Johnson MD, Burger GA. Epidural fentanyl for postcesarean delivery pain management. Anesthesiology 1985; 63: 694–8.
Brockway MS, Noble DW, Sharwood-Smith GH, McClure JH. Profound respiratory depression after extradural fentanyl. Br J Anaesth 1990; 64: 243–5.
Rosaeg OP, Suderman V, Yamell RW. Early respiratory depression during Caesarean section following epidural meperidine. Can J Anaesth 1992; 39: 71–4.
Melzack R. The short-form McGill Pain Questionnaire. Pain 1987; 30: 191–7.
Huskisson EC. Visual analogue scales.In: Melzack R (Ed.). Pain Measurement and Assessment. New York: Raven Press, 1983: 33–7.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yee, I., Carstoniu, J., Halpern, S. et al. A comparison of two doses of epidural fentanyl during Caesarean section. Can J Anaesth 40, 722–725 (1993). https://doi.org/10.1007/BF03009768
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03009768