Anesth Pain Med.  2008 Jul;3(3):210-213.

Comparison of Intrathecal Bupivacaine- Alfentanil and Bupivacaine-Fentanyl in Spinal Anesthesia for Cesarean Section

• Kim JH
• Hwang JW
• Oh AY
• Park HP
• Jeon YT
• Do SH

Abstract

BACKGROUND: Additive opioids in spinal anesthesia of cesarean section decrease the dose of local anesthetics and increase the quality of anesthesia. There were comparative studies about morphine, fentanyl, and sufentanil as an additive opioid in spinal anesthesia of cesarean section, but few studies about alfentanil. In this study we compared the effect of alfentanil with fentanyl as an additive opioid in spinal anesthesia for cesarean section.
METHODS
Sixty nine pregnant women, American Society of Anesthesiologist (ASA) I-II, who were scheduled for elective cesarean section under spinal anesthesia, were randomly allocated into two groups: group F received 8 mg (1.6 ml) of bupivacaine and 15microg of fentanyl (0.3 ml) intrathecally, and group A received 8 mg of bupivacaine and 150microg of alfentanil (0.3 ml). Sensory block defined by pin-prick, intraoperative patient satisfaction for analgesia by visual analogue scale (VAS), blood pressure, and side effects were assessed. Apgar score and umbilical arterial blood gas analysis were also assessed.
RESULTS
The analgesic effect of alfentanil was as good as fentanyl and VAS for satisfaction was 97.1 +/- 7.6 and 96.5 +/- 8.0 each. Time to achieve anesthetic level of T6 (6.2 vs 6.7 min), maximal block level (T3.7 vs T3.8), lowest blood pressure during the operation (60.0 vs 61.0 mmHg), duration of analgesia (77.2 vs 70.0 min), and fetal assessment were not different from those of group F, either. The incidence of nausea during operation was 48.6% in group F and 26.4% in group A (P = 0.14).
CONCLUSIONS
The addition of alfentanil is comparable to fentanyl in analgesia, maternal and fetal effects in spinal anesthesia for cesarean section.

Keyword

alfentanil; cesarean section; fentanyl; spinal anesthesia

MeSH Terms

Alfentanil
Analgesia
Analgesics, Opioid
Anesthesia
Anesthesia, Spinal
Anesthetics, Local
Apgar Score
Blood Gas Analysis
Blood Pressure
Bupivacaine
Cesarean Section
Female
Fentanyl
Humans
Incidence
Morphine
Nausea
Patient Satisfaction
Pregnancy
Pregnant Women
Sufentanil
Alfentanil
Analgesics, Opioid
Anesthetics, Local
Bupivacaine
Fentanyl
Morphine
Sufentanil