Epidural fentanyl, with and without epinephrine for post-Caesarean section analgesia

Using a double-bolus technique, the efficacy and safety of epidural fentanyl with and without epinephrine 1:400,000 for post-Caesarean section analgesia was examined in 30 patients. The addition of 25 micrograms epinephrine to the fentanyl (100 micrograms) did not potentiate the speed of onset but did significantly prolong the duration of action of the second dose. The only side effect encountered was pruritus, which was significantly increased (from 17-44 per cent) when epinephrine was added. The results indicate a clinical advantage of prolonging the duration of action of fentanyl for post-Caesarean Section analgesia with the addition of epinephrine, but the cumbersome and time-consuming nature of a double-bolus technique limits its clinical value. The relative safety of epidural fentanyl with and without epinephrine was confirmed by the absence of respiratory depression, drowsiness or hypotension in all patients.