The Effectiveness of Low Dose Fentanyl Bolus Injection in Cesarean Section after Umbilical Cord Clamping.
10.4097/kjae.2003.45.2.200
- Author:
Jun Seok BAE
1
;
Jong Nam LEE
;
Young Chul PARK
Author Information
1. Department of Anesthesiology, St. Benedict Hospital, Busan, Korea. soaf29@hanmail.net
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
bolus injection;
cesarean section;
fentanyl;
general anesthesia
- MeSH:
Anesthesia;
Anesthesia, General;
Anesthetics, Inhalation;
Arterial Pressure;
Atracurium;
Blood Pressure;
Cesarean Section*;
Constriction*;
Enflurane;
Female;
Fentanyl*;
Heart Rate;
Hemodynamics;
Humans;
Injections, Intravenous;
Intubation, Intratracheal;
Mothers;
Oxygen;
Postoperative Complications;
Pregnancy;
Succinylcholine;
Thiopental;
Umbilical Cord*;
Ventilation
- From:Korean Journal of Anesthesiology
2003;45(2):200-204
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: For anesthesia in cesarean section N2O and low concentrations of inhalation anesthetics are regarded as the anesthetic agent of choice. But a low level of anesthesia frequently leads to increased maternal hemodynamic responses and awareness. The effects of a 3 microgram/kg fentanyl bolus injection after umbilical cord clamping was evaluated in 20 full-term parturients, scheduled for elective cesarean section, versus to 20 parturients without fentanyl. METHODS: The forty parturients (ASA physical status 1, 2) scheduled for cesarean section were randomized to either a N2O-enflurane (E group) or a N2O-enflurane-fentanyl (F group). Thiopental sodium (4 mg/kg) and succinylcholine (1.5 mg/kg) were administered intravenously for the induction and endotracheal intubation. Anesthesia was maintained with 50% N2O and 1% enflurane in oxygen until delivery. After delivery, the intravenous injection of 0.5 mg/kg of atracurium was administered, controlled ventilation was applied to maintain PetCO2 at 30 to 35 mmHg with N2O (3 L/min) and O2 (1.5 L/min). Immediately after clamping the umbilical cord, 3 microgram/kg of fentanyl (F group only) was administered. Heart rate, blood pressure, awareness, recovery time, postoperative complication and recall were evaluated. RESULTS: Heart rate values at 10 and 20 min after umbilical cord clamping and 5 min after extubation, and mean arterial pressure at 5, 10 and 20 min after umbilical cord clamping in group F were found to be significantly lower than in group E. CONCLUSIONS: We conclude that N2O-enflurane-fentanyl at 3 microgram/kg is clinically satisfactory in anesthesia for cesarean section, having no adverse effects on the mother.
