Korean J Anesthesiol.  2003 Aug;45(2):200-204. 10.4097/kjae.2003.45.2.200.

The Effectiveness of Low Dose Fentanyl Bolus Injection in Cesarean Section after Umbilical Cord Clamping

• Bae JS
• Lee JN
• Park YC

• KMID: 2236715
• DOI: http://doi.org/10.4097/kjae.2003.45.2.200

Abstract

BACKGROUND: For anesthesia in cesarean section N2O and low concentrations of inhalation anesthetics are regarded as the anesthetic agent of choice. But a low level of anesthesia frequently leads to increased maternal hemodynamic responses and awareness. The effects of a 3 microgram/kg fentanyl bolus injection after umbilical cord clamping was evaluated in 20 full-term parturients, scheduled for elective cesarean section, versus to 20 parturients without fentanyl.
METHODS
The forty parturients (ASA physical status 1, 2) scheduled for cesarean section were randomized to either a N2O-enflurane (E group) or a N2O-enflurane-fentanyl (F group). Thiopental sodium (4 mg/kg) and succinylcholine (1.5 mg/kg) were administered intravenously for the induction and endotracheal intubation. Anesthesia was maintained with 50% N2O and 1% enflurane in oxygen until delivery. After delivery, the intravenous injection of 0.5 mg/kg of atracurium was administered, controlled ventilation was applied to maintain PetCO2 at 30 to 35 mmHg with N2O (3 L/min) and O2 (1.5 L/min). Immediately after clamping the umbilical cord, 3 microgram/kg of fentanyl (F group only) was administered. Heart rate, blood pressure, awareness, recovery time, postoperative complication and recall were evaluated.
RESULTS
Heart rate values at 10 and 20 min after umbilical cord clamping and 5 min after extubation, and mean arterial pressure at 5, 10 and 20 min after umbilical cord clamping in group F were found to be significantly lower than in group E.
CONCLUSIONS
We conclude that N2O-enflurane-fentanyl at 3 microgram/kg is clinically satisfactory in anesthesia for cesarean section, having no adverse effects on the mother.

Keyword

bolus injection; cesarean section; fentanyl; general anesthesia

MeSH Terms

Anesthesia
Anesthesia, General
Anesthetics, Inhalation
Arterial Pressure
Atracurium
Blood Pressure
Cesarean Section*
Constriction*
Enflurane
Female
Fentanyl*
Heart Rate
Hemodynamics
Humans
Injections, Intravenous
Intubation, Intratracheal
Mothers
Oxygen
Postoperative Complications
Pregnancy
Succinylcholine
Thiopental
Umbilical Cord*
Ventilation
Anesthetics, Inhalation
Atracurium
Enflurane
Fentanyl
Oxygen
Succinylcholine
Thiopental