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Does epidural fentanyl decrease the efficacy of epidural morphine after cesarean delivery?

R D Vincent1, D H Chestnut, W W Choi

  • 1Department of Anesthesia, University of Iowa College of Medicine, Iowa City 52242.

Anesthesia and Analgesia
|May 11, 1992
PubMed
Summary
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Epidural fentanyl did not improve pain relief during cesarean section surgery. However, it significantly reduced intraoperative nausea and vomiting without negatively impacting postoperative pain management with epidural morphine.

Area of Science:

  • Anesthesiology
  • Obstetrics
  • Pharmacology

Background:

  • Epidural fentanyl's role in intraoperative analgesia during cesarean delivery is debated.
  • Previous research indicates potential negative effects on postoperative analgesia from epidural morphine.

Purpose of the Study:

  • To evaluate if epidural fentanyl before epidural morphine enhances intraoperative anesthesia.
  • To determine if fentanyl administration compromises postoperative analgesia from morphine.

Main Methods:

  • A randomized, double-blind study involving 60 patients undergoing cesarean delivery.
  • Epidural anesthesia induced with lidocaine and epinephrine.
  • Patients received either epidural fentanyl (100 micrograms) or saline control post-delivery, followed by epidural morphine.

Related Experiment Videos

Main Results:

  • No significant difference in intraoperative pain scores between fentanyl and control groups.
  • Fentanyl group showed significantly reduced intraoperative nausea and vomiting (P = 0.013).
  • Postoperative pain, pruritus, nausea, and sedation scores were comparable between groups at 1, 2, 4, and 8 hours.

Conclusions:

  • Epidural fentanyl (100 micrograms) does not improve intraoperative analgesia during cesarean delivery.
  • Fentanyl significantly reduces intraoperative nausea and vomiting.
  • The use of epidural fentanyl does not diminish the effectiveness of subsequent epidural morphine for postoperative pain relief.