مقايسه فنتانيل و سوفنتانيل داخل نخاعي همراه ليدوكايين براي انجام اعمال جراحي سزارين الكتيو

Comparison of intrathecal fentanyl and sufentanil combined with lidocaine in elective cesarean section

Background: Use of opioids in spinal anesthesia is becoming increasingly popular in caesarian section. Opioids but however increase vomiting, nausea and itching reactions. We compared intrathecal use of either fentanyl or sufentanyl in cesarean section with respect to side effects during block and 24 hours later. We also compared duration of effective analgesia and pain intensity among study groups. Materials and methods: During this prospective double blind clinical study, 129 pregnant patients ASA Class 1 and 11, admitted for cesarean section at Emam Khomeini Hospital, Ahwaz. Patients were randomly assigned into 3 groups, 43 in each grouop. Patients had spinal anesthesia using 60 mg lidocaine with either 25 microgram fentanyl or 5 microgram sufentanil or equal volume of normal saline. Patients were followed up for incidence of vomiting, nausea and pain intensity for a period of 24 hours. Results: Patients in control group had mean analgesia time of 72±3.7 min, compared to 97.8± 4.2 min in sufentanyl group and 99± 2.3 min in fentanyl group (p <0.05). Mean VAS scores was 4.58±.82 in control group compared to 4.51± 1.8 and 3.25±0.81 in fentanyl and sufentanyl groups respectively. Patients in fentanyl group had highest rate of nausea and vomiting, during operation and on post op period. The difference was significantly higher than control group, but it was not significantly different from sufentanyl group.(p<0.05) Itching was not significantly different between all groups (p>0.05). Conclusion: According to statistical data analysis, intrathecal fentanyl and sufentanil can increase duration quality of analgesia during and in post op. in cesarean section. Side effects such as itching and respiratory depression are infrequent. Higher incidence of nausea and vomiting is seen with both fentayl and sufentanil which is probably easily correctable with anti emetics.