Beneficial effects of the addition of intrathecal fentanyl to bupivacaine for spinal anesthesia in cesarean section

ABSTRACT

BACKGROUND: The addition of fentanyl or epinephrine to bupivacaine enhances the quality of intraoperative spinal anesthesia during cesarean section. This study aimed to evaluate the beneficial effects of adding fentanyl or epinephrine to bupivacaine in spinal anesthesia solutions used for patients undergoing cesarean section. METHODS: This retrospective study included 391 patients who underwent cesarean section under spinal anesthesia between March 2009 and February 2014. Parturients were categorized into group N (no addition; n = 103), group E (addition of epinephrine; n = 196), and group F (addition of fentanyl; n = 92). Perioperative hemodynamic changes, complications, sensory recovery times, Apgar scores, and cord blood pH were analyzed. RESULTS: Nausea and vomiting occurred more frequently in group E than in the other two groups (P < 0.001 and P = 0.027, respectively). The mean sensory recovery times to T10 level showed statistically significant intergroup differences (P < 0.001). Group F showed the highest 1-min and 5-min Apgar scores, with statistically significant differences amongst the three groups (P = 0.007 and P < 0.001, respectively). However, the blood gas analysis variables of the cord blood did not show significant differences. CONCLUSIONS: Addition of fentanyl to bupivacaine was related to a longer sensory recovery time than did the addition of nothing or epinephrine. Moreover, it had been associated with beneficial effects such as a reduction in complications following spinal anesthesia.