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Korean J Anesthesiol. 1994 Jul;27(7):792-799. Korean. Original Article.
Shim JC .
Department of Anesthesiology, College of Medicine, Hanyang University, Seoul, Korea.

The rapid onset of epidural fentanyl could be used to cover the latency period of epidural marphine, thus potentiating analgesia during anesthesia regression after short acting local anesthetics and possibly extending the morphine analgesia for longer duration. The study was designed to determine whether epidural fentanyl given before epidural morphine improves the quality of intraoperative epidural anesthesia without worsening postoperative analgesia provided by epidural morphine. Epidural anesthesia was established using 2% lidocaine with epinephrine 5 ug/ml. Patients scheduled for study was assigned to two groups (n=20 for each). Group 1 receiving epidural normal saline-control 10 ml, and Group 2 receiving epidural fentanyl 100 ug (10 ug/ml) through epidural catheter after delivery. After uterine repair epidural morphine 10 ml (0.3 mg/ml) was injected through epidural catheter. Patients were surveyed regarding their impression on intraoperative analgesia, nausea and postoperative analgesia, vomiting, pruritis, sedation. No significant difference was found in the two groups for intraoperative analgesia, nausea and vomiting. Postoperatively, visual analogue score for pain, vomiting, pruritis, sedation were similar at 1,2,4,8 hours in the two groups. In conclusion, epidural fentanyl 100 ug after delivery did not improve the intraoperative pain, nausea and early postoperative pain.

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