The use of fentanyl added to morphine-lidocaine-epinephrine spinal solution in patients undergoing cesarean section
| Autor: | Venesa Ingold, Steven M. Dunn, Neil Roy Connelly, Evelyn A. Villa |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Anesthesia
Epidural medicine.medical_specialty Lidocaine Epinephrine Visual analogue scale medicine.medical_treatment Anesthesia Spinal Fentanyl Pacu Pregnancy medicine Anesthesia Obstetrical Humans Saline biology Morphine business.industry Cesarean Section Infant Newborn biology.organism_classification Surgery Anesthesiology and Pain Medicine Elective Surgical Procedures Anesthesia Female Onset of action business medicine.drug |
| Zdroj: | Anesthesia and analgesia. 78(5) |
| ISSN: | 0003-2999 |
| Popis: | Because of its slow onset of action, intrathecal morphine may not be the optimal drug for intraoperative analgesia during short cases, such as cesarean sections. It is not known whether adding fentanyl to a morphine-lidocaine spinal solution would provide any benefits to patients undergoing cesarean sections. Sixty-two women scheduled for elective cesarean section received intrathecal 5% lidocaine with dextrose (50-70 mg), epinephrine 200 micrograms, preservative-free morphine 0.2 mg, and either 10 micrograms of fentanyl (study group) or preservative-free normal saline (placebo group) in a 0.2-mL volume. Patients were asked to rate their severity of pain on a visual analog scale (VAS) intraoperatively as the uterus was exteriorized and again when the dermatomal level had receded to L1. Intravenous fentanyl was administered if the patient experienced intraoperative discomfort. The VAS scores were 0.8 +/- 1.5 and 2.3 +/- 1.6 (mean +/- SD) in the placebo group at the time of uterine extrusion and in the post-anesthesia care unit (PACU). The corresponding scores in the fentanyl group were 0.4 +/- 1.1 and 2.7 +/- 2.2. There was a significant difference between the two groups in the VAS scores intraoperatively (P < 0.014) but not in the PACU (P not significant). There was also a significant difference (P < 0.015) in the need for supplementation with intravenous (i.v.) fentanyl. Six patients in the placebo group received i.v. fentanyl as compared with none of the patients in the fentanyl group.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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