Comparison of the Maternal and Neonatal Effects of Intratechal Bupivacaine Plus Fentanyl or Morphine During Cesarean Delivery

Abstract

Aim: To evaluate the effects of morphine and fentanyl added to bupivacaine and intrathecal bupivacaine to combine spinal-epidural anaesthesia during caesarean. Methods: Forty subjects with American Society of Anesthesiologists I-II status who would have caesarean were included in the study. The subjects were divided into two groups. Group bupivacaine-fentanyl (BF) were given 0.5% bupivacaine 7.5 mg + 25 µg fentanyl and group bupivacaine-morphine (BM) received 0.5% bupivacaine 7.5 mg + 0.1 mg morphine intrathecal total 2 mL. Periods for access to T4 block, two dermatome regression of sensory block, time elapsed between the administration of the local anaesthetic and reaching Bromage scale 1, reaching the highest level of motor block, first analgesic necessity, umbilical cord clamping time, and when the operation ends were recorded. One-minute and five-minute Apgar scores, umbilical blood gas values of the newborns and the adverse effects were recorded. Results: Comparisons between the two groups show that group BM has longer periods for motor block start time, two dermatome regression time, and first anaesthetic necessity time and group BF had higher levels for motor block level at the 1st minute and visual analog scale scores at postop 60th minute. There was no significant difference between the groups for the adverse effects. Conclusion: Fentanyl and morphine added to intrathecal bupivacaine show similar effects in intraoperative analgesia. We have deduced that although low doses of hyperbaric bupivacaine is effective during caesarean section, fentanyl and morphine added to bupivacaine can also be used safely and effectively.

Keywords

• Pupivacaine
• cesarean
• fentanyl
• morphine