Efficacy of the addition of intrathecal fentanyl for the prevention of nausea and vomiting during cesarean delivery under spinal anesthesia
- Author:
Atienza Ian Antonio
;
Hernandez Erica Frances
;
Noel Marie Eugenie
- Publication Type:Journal Article
- MeSH:
Human;
Female;
CESAREAN SECTION;
ANESTHESIA, SPINAL;
FENTANYL
- From:
Philippine Journal of Anesthesiology
2007;19(2):60-67
- CountryPhilippines
- Language:English
-
Abstract:
Nausae and vomiting remains as "the big little problem" in cesarean delivery under spinal anesthesia, attributable to the discomfort from intraoperativeperitoneal manipulations. Recent studies have reported that intrathecal (IT) administration of lipophilic opioids, such as fentanyl, minimizes this discomfort by by improving the qulity ad duration of pain relief when it is combined with 0.5% bupicavaine used for subarachnoid block in cesarean delivery. It ws the objective of this study to determine the efficacy of the addition of intrathecal fentanyl for the prevention of nausea and vomiting during cesarean section under spinal anesthesia.
Methods: The comparison of the antiemetic efficacy of 12.5 ug and 25 ug IT and its effects on the onset and duration of hyperbaric bupicavaine induced senory and motor spinal block were observed. Maternal nd fetal adverse effects were, likewise, documented. Forty-five full-term parturients of American Society of Anesthesiologist Physical Status I, scheduled for eective cesarean delivery at the Philippine General Hospital were included in the study.
Result: Results revealed that both IT fentanyl 12.5 ug and 25 ug significantly prevented nausea and vomiting during cesarean delivery undr spinal anesthesia i comprison with IT placebo. Furthermore, in comparing the efficacy of the IT fentanyl groups, there was no significant difference between the two groups. There were no notable effects on the co-administration of IT fentanyl on the onset and duration of hyperbaric bupicavaine induced sensory and motor spinal block.
Conclusion: Common hemodyamic responses and side effects of spnal anesthesia and addition of low dose IT fentanyl (i.e. hypotension, respiratory depression, shvering pruritus) di not show deleterious effects to the parturients. the low dose IT fentanyl used in the study had no detectable adverse impact on neonatal condition, when assessed by APGAR scoring.
