மயக்க மருந்து & மருத்துவ ஆராய்ச்சி
திறந்த அணுகல்

சுருக்கம்

Comparison of Two Different Doses of Fentanyl Combined With Levobupivacaine For Elective Cesarean Section

Muge Arikan, Bilge Aslan, Eyup Horasanli and Abdulkadir But

Objectives: In this prospective, randomized, double-blind, controlled study, we compared the effects of two different doses of fentanyl (10 μg or 25 μg) given intrathecally in addition to 0.5% levobupivacaine for cesarean section. Methods: Eight hundred, ASA I-II parturients, who were scheduled for elective cesarean section, were enrolled in the study. They were randomly allocated into three groups. Group I received 0.5% levobupivacaine; Group II received 0.5% levobupivacaine plus 15 μg fentanyl; Group III received 0.5% levobupivacaine plus 25 μg fentanyl intrathecally. Ephedrine was administered as a bolus dose (0.1 mg/kg), and then the continuous infusion was initiated. The rate of infusion was maintained with respect to baseline systolic blood pressure until umbilical cord clamping. We recorded maternal sistolic blood pressure, heart rate, total ephedrine dose, fetal Apgar scores (at 1st and 5th min), and umbilical cord blood parameters. Other side effects, such as hypotension, nausea/vomiting, bradycardia, etc. were also noted. Results: Bolus, infusion and total ephedrine doses were significantly lower in Group III when compared with the other groups (P<0.05). The incidences of hypotension in the I, II, and III groups were 17.30%, 13.38%, and 11.63%, respectively. There was no significant difference between the three groups regarding the Apgar scores at the 1st or 5th min, umbilical arterial or venous pH. There was no difference in the incidence of other side effects among the three groups. Conclusion: We conclude that the addition of 25 μg fentanyl to adjusting the dose of levobupivacaine to a patient's height decreases the ephedrine requirement without additional side effects and adverse neonatal outcomes when compared with the other groups. The levobupivacaine doses as determined by the length of the patients’ and the use of the appropriate fluid resuscitation therapy with an infusion of ephedrine can be used effective methods.