Perioperative analgesia after intrathecal fentanyl and morphine or morphine alone for cesarean section: A randomized controlled study

• Published in: Medicine (Baltimore) 2017-12, Vol.96 (48), p.e8892-e8892
• Main Authors: Weigl, Wojciech, Bieryło, Andrzej, Wielgus, Monika, Krzemień-Wiczyńska, Świetlana, Kołacz, Marcin, Dąbrowski, Michał J.
• Format: Article
• Language: English
• Subjects: acute opioid tolerance; Adolescent; Adult; Analgesics, Opioid - therapeutic use; Anesthesia, Spinal - methods; Cesarean Section; Clinical Trial/Experimental Study; Double-Blind Method; Female; Fentanyl - therapeutic use; Humans; hydrophilic and lipophilic opioids; Middle Aged; Morphine - therapeutic use; Pain Measurement; Pain, Postoperative - prevention & control; patient-controlled analgesia (PCA); post-caesarean pain management; Pregnancy; Prospective Studies; spinal anesthesia; spinal opioids; superiority and noninferiority trial; Treatment Outcome
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000008892

Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS. Spinal anesthesia consisted of bupivacaine with either morphine 100 μg (M group), or fentanyl 25 μg and morphine 100 μg (FM group). The frequency of intraoperative pain and pethidine consumption in the 24 hours postoperatively was recorded. Fewer patients in the FM group required additional intraoperative analgesia (P