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Obstetric Anesthesia
Anesthesia and Pain Medicine 2008;3(3):210-213.
Published online July 30, 2008.
Comparison of Intrathecal Bupivacaine- Alfentanil and Bupivacaine-Fentanyl in Spinal Anesthesia for Cesarean Section
Jang Hyun Kim, Jung Won Hwang, Ah Young Oh, Hee Pyoung Park, Young Tae Jeon, Sang Hwan Do
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Seoul National University College of Medicine, Korea.
2Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Seoul National University College of Medicine, Korea. jungwon@snubh.org
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.
Key Words: alfentanil, cesarean section, fentanyl, spinal anesthesia


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