Epidural fentanyl and 0.5% bupivacaine for elective Caesarean section

King, M. J.; Bowden, M I; Cooper, G. M.

doi:10.1111/j.1365-2044.1990.tb14733.x

Cited by 37 publications

(15 citation statements)

References 15 publications

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“…It was noted that the onset is more rapid and anesthesia more complete and more prolonged when fentanyl is added to bupivacaine solutions for regional anesthesia. 11 Some receptors mediate nociception on peripheral sensory axons, and the peripheral administration of opioids has analgesic effects. The mechanisms of the analgesic effects of these drugs are unclear.…”

Section: Discussionmentioning

confidence: 99%

Addition of fentanyl to bupivacaine prolongs anesthesia and analgesia in axillary brachial plexus block

Karakaya

Büyükgöz

Barış

et al. 2001

Regional Anesthesia and Pain Medicine

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Section: Discussionmentioning

confidence: 99%

Addition of fentanyl to bupivacaine prolongs anesthesia and analgesia in axillary brachial plexus block

Karakaya

Büyükgöz

Barış

et al. 2001

Regional Anesthesia and Pain Medicine

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“…Fentanyl in combination with bupivacaine has been shown to improve the quality of analgesia during elective Caesarean section [11]. We do not routinely use fentanyl to extend epidural analgesia for emergency Caesarean section if patients have received regular epidural fentanyl as part of the low-dose regimen, and our study was designed to compare three local anaesthetic solutions without the effects of additives.…”

Section: Discussionmentioning

confidence: 99%

Extending low‐dose epidural analgesia for emergency Caesarean sectionA comparison of three solutions

Lucas

Ciccone²,

Yentis

1999

Anaesthesia

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SummaryWe conducted a prospective double-blind randomised trial to compare bupivacaine 0.5%; a 50 : 50 mixture of bupivacaine 0.5%/lignocaine 2% with 1 : 200 000 adrenaline (final concentration); and lignocaine 2% with 1 : 200 000 adrenaline for converting a low-dose labour epidural into a block adequate for emergency Caesarean section. Ninety patients were studied, 30 in each group. There was no difference between the groups in the time taken for bilateral loss of cold sensation to reach T 4 . Onset time was unaffected by the existing sensory level pre-Caesarean section top-up; the number of low-dose top-ups in labour; the total dose of bupivacaine in labour; or maternal weight or height. Three patients in the lignocaine with adrenaline group had blocks that reached the cervical dermatomes and three in the same group required general anaesthesia for inadequate anaesthesia, compared with none in the other groups (both p ¼ 0.04).

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“…Fentanyl has been shown to have a local anaesthetic sparing effect during labour [8], and addition of fentanyl to bupivacaine has been shown to improve the quality of anaesthesia during elective Caesarean section [9,10]. In our unit, fentanyl is often combined with levobupivacaine at the time of an emergency Caesarean section in the belief that it improves the quality of analgesia and ⁄ or the onset time of the block.…”

Section: Discussionmentioning

confidence: 99%

Extending low‐dose epidural analgesia in labour for emergency Caesarean section – a comparison of levobupivacaine with or without fentanyl*

Malhotra

Yentis

2007

Anaesthesia

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SummaryWomen in labour receiving epidural analgesia with 15 ml bupivacaine 0.1% and 2 lg.ml )1 fentanyl followed by 10-15-ml top-ups as required, who needed Caesarean section, were randomly allocated to receive 20 ml levobupivacaine 0.5% over 3 min with either 75 lg fentanyl (1.5 ml) or 1.5 ml saline. Further top-ups or inhaled or intravenous supplementation were given for breakthrough pain. Time to onset (loss of cold sensation to T4 and touch sensation to T5 bilaterally), quality of analgesia and side-effects were recorded. The study was stopped after 112 patients had been randomly assigned, due to a unit protocol change, from midwife-administered top-ups to patient-controlled epidural analgesia. Data from 51 patients given fentanyl and 54 given saline were available for analysis. There were no significant differences in onset times or supplementation between the groups, but there was more intra-operative nausea ⁄ vomiting with fentanyl (53%) than with saline (18%; p = 0.004). We found no advantage of adding fentanyl to epidural levobupivacaine when extending epidural analgesia in women already receiving epidural fentanyl during labour and there was an increased incidence of intra-operative nausea and vomiting. Power analysis suggested the same conclusion even had the study proceeded to completion.

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Epidural fentanyl and 0.5% bupivacaine for elective Caesarean section

Abstract: Summary

Cited by 37 publications

References 15 publications

Addition of fentanyl to bupivacaine prolongs anesthesia and analgesia in axillary brachial plexus block

Addition of fentanyl to bupivacaine prolongs anesthesia and analgesia in axillary brachial plexus block

Extending low‐dose epidural analgesia for emergency Caesarean sectionA comparison of three solutions

Extending low‐dose epidural analgesia in labour for emergency Caesarean section – a comparison of levobupivacaine with or without fentanyl*

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