Document Type : Original Article
Authors
1
Assistant Professor of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2
Assistant Professor of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3
Anesthesiologist, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4
Associate Professor of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
5
Resident of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
6
Resident of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Introduction: Cesarean section is vastly used for child bearing. Spinal analgesia is a preferable method in Cesarean because of its fewer complications. Adding opioid to the anesthetic medicine improves the analgesic potency and quality of spinal analgesia. The purpose of this study was to evaluate the effect of regular-dose of bupivacain (marcain) and low-dose of bupivacain plus fentanyl in spinal anesthesia on neonatal apgar score and time of regression of sensory block in elective cesarean section under.
Methods: This clinical trial was performed on 100 pregnant women who had chosen elective cesarean section under spinal analgesia in 2010. Patients were divided into two equal groups of 50 persons: first group received 12 mg intra theca hyperbaric bupivacain and second group received 8 mg bupivacain with additional 25 microgram of fentanyl spinal injection. Considering parameters including: duration and level of sensory block, neonatal apgar score, hemodynamic stability, and other side effects; both groups were evaluated and compared. Gathered data were analyzed by SPSS software version 11.5, T-Test, Man-Whitney and qui-square tests. P value less than 0.05 was considered statistically significant.
Results: Mean age of all the participants were 28.18±5.4 (minimum age 16 and maximum age 41). Both groups were similarin age, weight, height, and hemodynamic condition. All patients had satisfactory anesthesia. The time of sensory-block regression was not statistically different in both groups (p=0.482), but the level of sensory block was higher than T4 in the first group. Median of blood pressure, pulse rate and PO2 saturation were similar in both groups (p>0.05). Ephedrine requirement (because of decrease of blood-pressure) and nausea were significantly more in the first group, (p=0.017 and p=0.014, respectively). There was no significant difference between two groups in the first minute of neonatal apgar score, but the 5th minute apgar score was significantly less in the first group (p=0.043).
Conclusion: Adding fentanyl to low-dose of bupivacain provides good spinal anesthesia for cesarean section with fewer side effects, and satisfactory sensory block level but it has no adverse effect on neonatal apgar score.
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