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Mohtadi AR, Ahmadi Chegeni A, Behaeen K, Savaie M, Ghomeishi A. Post-cesarean Delivery Analgesia Using Spinal Anesthesia: Ropivacaine-Fentanyl vs. Ropivacaine-Sufentanil. Anesth Pain Med 2023; 13:e138067. [PMID: 38024008 PMCID: PMC10676674 DOI: 10.5812/aapm-138067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/01/2023] [Accepted: 07/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background To improve the quality of intraoperative and postoperative analgesia during spinal anesthesia, intrathecal opioids are used as adjuvant drugs in combination with local anesthetics. Objectives This study aimed to compare the intrathecal injection of ropivacaine-fentanyl with ropivacaine-sufentanil in terms of the duration of analgesia after cesarean section (CS). Methods This randomized, double-blind clinical trial study was conducted on women referred to Imam Khomeini Hospital of Ahvaz City for elective CS in 2021. A total of 51 patients were randomly divided into 2 groups. The first group (n = 25) received ropivacaine (17.5 mg) + fentanyl (25 μg), while the second group (n = 26) received ropivacaine (17.5 mg) + sufentanil (2.5 μg) for spinal anesthesia. Eventually, several parameters were investigated, including the duration of sensory and motor block, duration of analgesia (based on the Visual Analog Scale (VAS)), hemodynamic parameters, and possible complications. Results The duration of surgery (P = 0.059) and the duration of motor block (P = 0.962) were not significantly different between the 2 groups. The mean duration of analgesia (from the time of entering recovery to reaching VAS = 3) was 203.12 ± 72.93 and 207.46 ± 69.59 minutes in the fentanyl and sufentanil groups, respectively (P = 0.658). Systolic and diastolic blood pressure (SBP/DBP) drops in minute 5 were observed more frequently in the sufentanil group than in the fentanyl group (P = 0.027 and P = 0.002, respectively). At the other time points, however, no significant difference was observed between the 2 groups in terms of hemodynamic variables (P > 0.05). Finally, the frequency of pruritus was higher in the sufentanil group than in the fentanyl group (26.9% vs. 4.0%; P = 0.024). Conclusions Adding fentanyl or sufentanil to intrathecal ropivacaine provides a similar duration of analgesia. However, fentanyl was associated with better hemodynamic stability and a lower incidence of pruritus.
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Affiliation(s)
- Ahmad Reza Mohtadi
- Department of Anesthesiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Atusa Ahmadi Chegeni
- Department of Anesthesiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kaveh Behaeen
- Department of Anesthesiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohsen Savaie
- Department of Anesthesiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Ghomeishi
- Department of Anesthesiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Pain Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Mostic Stanisic D, Kalezic N, Rajovic N, Ilic Mostic T, Cumic J, Stanisavljevic T, Beleslin A, Stulic J, Rudic I, Divac N, Milic N, Stojanovic R. Effect of regional vs general anesthesia on vital functions after cesarean section: a single center experience. Hypertens Pregnancy 2022; 41:198-203. [DOI: 10.1080/10641955.2022.2124417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Danka Mostic Stanisic
- Clinic for Gynecology and Obstetrics, Clinical Center “Dragisa Misovic–Dedinje”, Belgrade, Serbia
- Clinic of Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia
| | - Nevena Kalezic
- Faculty of Medicine University of Belgrade, Belgrade, Serbia
- Department of Anesthesiology, Clinic of Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia
| | - Nina Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Tatjana Ilic Mostic
- Department of Anesthesiology, Clinic of Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia
| | - Jelena Cumic
- Department of Anesthesiology, Clinic for Cardiac Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | | | - Aleksandra Beleslin
- Clinic of Gynecology and Obstetrics, Clinical Centre of Serbia, Belgrade, Serbia
| | - Jelena Stulic
- Clinic for Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
| | - Ivana Rudic
- Clinic for Gynecology and Obstetrics “Narodni Front”, Belgrade, Serbia
| | - Nevena Divac
- Institute for Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine University of Belgrade, Serbia
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, Belgrade, Serbia
- Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA
| | - Radan Stojanovic
- Institute for Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine University of Belgrade, Serbia
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Kulkarni SS, Tayade DN, Parchandekar MK, Nayak PP, Kelkar VP, Pachore PJ. Major neurological complications following central neuraxial blockade - A multicentre pilot study in Aurangabad city (MGMA CNB Study). Indian J Anaesth 2021; 65:684-694. [PMID: 34764504 PMCID: PMC8577715 DOI: 10.4103/ija.ija_639_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 01/21/2023] Open
Abstract
Background and Aims Incidence of major neurological complications following central neuraxial blockade (CNB) in India is not known. This information is essential for explaining risk preoperatively to patients and for medico-legal purposes. This study was undertaken to assess feasibility (recruitment process, protocol adherence, resources mobilisation, data management and evaluation of scientific outcome) for planning multicentric studies on major neurological complications following CNB at state/national level. Methods This was a hospital-based, multicentre pilot study, with cross-sectional and follow-up components. Patients receiving CNB either perioperatively or during acute/chronic pain management were included in the study. Thirty-six randomly selected tertiary and nontertiary care institutes were included. Details of demographic information, CNB procedure and major neurological complications were collected anonymously via online tools. Feedback about study feasibility was collected from participating anaesthesiologists and study team. Results Selected institutes continued participation throughout study period. About 99.98% of eligible patients were enroled. Complete data collection of 8053 patients and analysis was possible. Regular reminders from study coordinators helped to optimise data collection. Tertiary care institutes contributed to 74.50% of data. About 64.96% patients were females. Spinal anaesthesia was the most frequently used neuraxial block (93.41%). Bupivacaine and adjuvant were used in 95.53% and 16.5% patients, respectively. Two patients developed cardiac arrest and cause-effect relationship with CNB was established. Participants' recruitment, protocol adherence, resources mobilisation, data management and evaluation of scientific outcomes were feasible. Conclusion A multicentre state/nationwide study can be conducted based on this first-of-its-kind pilot study in India.
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Affiliation(s)
- Sadhana Sudhir Kulkarni
- Department of Emergency Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
| | - Deepak Narayan Tayade
- Department of Community Medicine, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
| | | | - Prabha Pandurang Nayak
- Department of Anaesthesiology, MGM Medical College and Hospital, Aurangabad, Maharashtra, India
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Gayathri B, Swetha Ramani CK, Urkavalan K, Pushparani A, Rajendran A. Comparison of the time taken for subarachnoid block using ultrasound-guided method versus landmark technique for cesarean section - A randomized controlled study. J Anaesthesiol Clin Pharmacol 2021; 37:205-209. [PMID: 34349367 PMCID: PMC8289655 DOI: 10.4103/joacp.joacp_35_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 10/08/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Spinal anesthesia is the regional technique preferred for cesarean section and is usually administered using the traditional landmark technique. Ultrasonography of the spine appears to be helpful in locating the puncture site and increasing the success rate. The primary objective of this study was to assess the use of ultrasonogram in locating the lumbar interspinous space for spinal anesthesia in laboring parturients brought for elective cesarean section. Material and Methods: Sixty parturients scheduled to undergo elective cesarean section under spinal anesthesia were included in this prospective randomized controlled trial, after obtaining the institutional ethical clearance. In Group I, 30 patients received spinal anesthesia by landmark technique and in Group II, 30 patients underwent ultrasound-guided spinal anesthesia. The statistical analysis was done using SPSS software version 17 (SPSS Inc., Chicago, Illinois, USA) for Microsoft windows. Results: The time taken for spinal in Group I was longer than in Group II (62 ± 18s; 41 ± 11s; P = 0.0001). The number of attempts of needle insertion was significantly less in Group II (group I 1.86 ± 1.04: group II 1.06 ± 0.25). However, the total preparation time (28 8.30 ± 92 vs 804.73 ± 77; P = 0.0001) was more in the ultrasound-guided than in the landmark group. The patients had better satisfaction in group II. Conclusion: Preprocedural ultrasound is a useful tool for successful lumbar puncture in parturients as it minimizes the number of attempts of needle insertion and provides better patient satisfaction.
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Affiliation(s)
- B Gayathri
- Department of Anaesthesiology, SRM Medical College Hospital and Research Centre, Chengalpattu, Tamil Nadu, India
| | - C K Swetha Ramani
- Department of Anaesthesiology, SRM Medical College Hospital and Research Centre, Chengalpattu, Tamil Nadu, India
| | - Karthika Urkavalan
- Department of Anaesthesiology, SRM Medical College Hospital and Research Centre, Chengalpattu, Tamil Nadu, India
| | - A Pushparani
- Department of Anaesthesiology, SRM Medical College Hospital and Research Centre, Chengalpattu, Tamil Nadu, India
| | - A Rajendran
- Department of Anaesthesiology, Government Dharmapuri Medical College Hospital, Dharmapuri, Tamil Nadu, India
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Eskandr AM, Ahmed AM, Bahgat NME. Comparative Study Among Ephedrine, Norepinephrine and Phenylephrine Infusions to Prevent Spinal Hypotension During Cesarean Section. A Randomized Controlled Double-Blind Study. EGYPTIAN JOURNAL OF ANAESTHESIA 2021. [DOI: 10.1080/11101849.2021.1936841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Ashraf M Eskandr
- Assistant Professor in Anesthesiology and Intensive Care Department, Faculty of Medicine, Menoufia University, Quisna, Egypt
| | - Ali M Ahmed
- Senior Registrar in Anesthesiology, and Intensive Care Department, General Sohag Health Hospital, Sohag, Egypt
| | - Nadia Mohee Eldin Bahgat
- Lecturer in Anesthesiology and Intensive Care Department, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
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Singariya G, Choudhary K, Kamal M, Bihani P, Pahuja H, Saini P. Comparison of analgesic efficacy of intrathecal 1% 2-chloroprocaine with or without fentanyl in elective caesarean section: A prospective, double-blind, randomised study. Indian J Anaesth 2021; 65:102-107. [PMID: 33776083 PMCID: PMC7983823 DOI: 10.4103/ija.ija_816_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/22/2020] [Accepted: 02/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Aims: Preservative free 1% 2-chlorprocaine is a short acting local anaesthetic agent suitable for day care surgical procedures. Potentiation of analgesic action of intrathecal local anaesthetics by the addition of opioids is well known. In this study, we investigated the effect of intrathecal fentanyl as an adjuvant to 1% 2-chloroprocaine (2-CP) in parturients undergoing elective lower segment caesarean section (LSCS). Methods: This prospective randomised comparative study was performed on 150 healthy, term parturients planned for elective low risk LSCS, divided into two equal groups. The group CS received 1% preservative-free 2-CP 3 ml (30 mg) + 0.5 ml normal saline and group CF received 1% preservative-free 2-CP 3 ml (30 mg) + 0.5 ml fentanyl (25 μg) with a total volume of 3.5 ml intrathecally in both groups. The duration of sensory blockade, duration of motor blockade, maximum height of sensory block, haemodynamic parameters, quality of block, neonatal outcome, patient satisfaction and any side effects were recorded. Results: There were no significant differences in demographic characteristics, haemodynamic parameters, onset of sensory block, onset of motor block and duration of motor block between the groups. The duration of sensory block and duration of analgesia was statistically prolonged in group CF than group CS (P value < 0.0001). There was no statistical difference in the Apgar score of newborns in both groups. The adverse effects (hypotension, bradycardia, nausea/vomiting, shivering and transient neurological symptoms) were comparable in both the groups. Conclusion: The addition of fentanyl to 1% 2-chloroprocaine intrathecally prolonged the duration of sensory block and postoperative analgesia in patients undergoing LSCS.
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Affiliation(s)
- Geeta Singariya
- Department of Anaesthesiology and Critical Care, Dr S N Medical College, Jodhpur, Rajasthan, India
| | - Kusum Choudhary
- Department of Anaesthesiology and Critical Care, Dr S N Medical College, Jodhpur, Rajasthan, India
| | - Manoj Kamal
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Pooja Bihani
- Department of Anaesthesiology and Critical Care, Dr S N Medical College, Jodhpur, Rajasthan, India
| | - Himani Pahuja
- Department of Anaesthesiology and Critical Care, Dr S N Medical College, Jodhpur, Rajasthan, India
| | - Pradeep Saini
- Department of Anaesthesiology and Critical Care, Dr S N Medical College, Jodhpur, Rajasthan, India
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Shah PJ, Agrawal P, Beldar RK. Intravenous norepinephrine and mephentermine for maintenance of blood pressure during spinal anaesthesia for caesarean section: An interventional double-blinded randomised trial. Indian J Anaesth 2020; 64:S235-S241. [PMID: 33311725 PMCID: PMC7714008 DOI: 10.4103/ija.ija_91_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/20/2020] [Accepted: 07/23/2020] [Indexed: 01/18/2023] Open
Abstract
Background and Aims: Spinal anaesthesia induced hypotension (SAIH) and bradycardia may prove deleterious to both parturient and baby, hence vasopressors play a vital role in their management. Recent studies on norepinephrine as rescue vasopressor during subarachnoid block (SAB) enlighten its role for SAIH. This randomised double-blind trial was conducted to compare the effect of intermittent intravenous boluses of norepinephrine and frequently used mephentermine for management of SAIH in caesarean section (CS) to prove whether norepinephrine produces comparable effects or superior to mephentermine. Methods: After approval from Institutional Ethics Committee and registration in Clinical Trials Registry India (CTRI/2019/06/019652), 256 parturients posted for elective CS under SAB were randomly allocated into Group-N and Group-M (n = 84) using chit system, who received boluses of intravenous norepinephrine 8μg and mephentermine 6mg for SAIH, respectively. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), Response%, Apgar score and maternal complications were analysed. Results: The changes in SBP and DBP were comparable in both the groups. It was significantly low after SAB compared to baseline and significantly high compared to 1st hypotensive value in both the groups throughout the study period (<0.0001). HR was comparable for initial 10 min, thereafter it was significantly high in Group-M (<0.0001) till 40 min. Response% after the first bolus was significantly high in Group-N (59.30n ± 29.21 vs 39.78 ± 25.6; P = <0.0001). Conclusion: Intravenous norepinephrine is better than mephentermine with respect to high response% and stable maternal HR although both are equally effective in maintaining blood pressure following SAIH during elective CS.
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Affiliation(s)
- Pratibha Jain Shah
- Department of Anaesthesiology and Critical Care, Pt JNM Medical College, Raipur, Chhattisgarh, India
| | - Pratiksha Agrawal
- Department of Anaesthesiology and Critical Care, Pt JNM Medical College, Raipur, Chhattisgarh, India
| | - Rajesh Kumar Beldar
- Department of Anaesthesiology and Critical Care, Pt JNM Medical College, Raipur, Chhattisgarh, India
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Sato I, Iwasaki H, Luthe SK, Iida T, Kanda H. Comparison of intrathecal morphine with continuous patient-controlled epidural anesthesia versus intrathecal morphine alone for post-cesarean section analgesia: a randomized controlled trial. BMC Anesthesiol 2020; 20:138. [PMID: 32493372 PMCID: PMC7268233 DOI: 10.1186/s12871-020-01050-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 05/24/2020] [Indexed: 12/02/2022] Open
Abstract
Background Several neuraxial techniques have demonstrated effective post-cesarean section analgesia. According to previous reports, it is likely that patient-controlled epidural analgesia (PCEA) without opioids is inferior to intrathecal morphine (IM) alone for post-cesarean section analgesia. However, little is known whether adding PCEA to IM is effective or not. The aim of this study was to compare post-cesarean section analgesia between IM with PCEA and IM alone. Methods Fifty patients undergoing elective cesarean section were enrolled in this prospective randomized study. Patients were randomized to one of two groups: IM group and IM + PCEA group. All patients received spinal anesthesia with 12 mg of 0.5% hyperbaric bupivacaine, 10 μg of fentanyl, and 150 μg of morphine. Patients in IM + PCEA group received epidural catheterization through Th11–12 or Th12-L1 before spinal anesthesia and PCEA (basal 0.167% levobupivacaine infusion rate of 6 mL/h, bolus dose of 3 mL in lockout interval of 30 min) was commenced at the end of surgery. A numerical rating scale (NRS) at rest and on movement at 4,8,12,24,48 h after the intrathecal administration of morphine were recorded. In addition, we recorded the incidence of delayed ambulation and the number of patients who requested rescue analgesics. We examined NRS using Bonferroni’s multiple comparison test following repeated measures analysis of variance; p < 0.05 was considered as statistically significant. Results Twenty-three patients in each group were finally analyzed. Mean NRS at rest was significantly higher in IM group than in IM + PCEA group at 4 (2.7 vs 0.6), 8 (2.2 vs 0.6), and 12 h (2.5 vs 0.7), and NRS during mobilization was significantly higher in IM group than in IM + PCEA group at 4 (4.9 vs 1.5), 8 (4.8 vs 1.9), 12 (4.9 vs 2), and 24 h (5.7 vs 3.5). The number of patients who required rescue analgesics during the first 24 h was significantly higher in IM group compared to IM + PCEA group. No significant difference was observed between the groups in incidence of delayed ambulation. Conclusions The combined use of PCEA with IM provided better post-cesarean section analgesia compared to IM alone. Trial registration UMIN-CTR (Registration No. UMIN000032475). Registered 6 May 2018 – Retrospectively registered.
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Affiliation(s)
- Izumi Sato
- Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
| | - Hajime Iwasaki
- Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan.
| | - Sarah Kyuragi Luthe
- Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan.,Department of Anesthesiology, Indiana University School of Medicine, 1130 W. Michigan Street, Fesler Hall 204, Indianapolis, IN, 46202, USA
| | - Takafumi Iida
- Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
| | - Hirotsugu Kanda
- Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Midorigaoka-higashi 2-1-1-1, Asahikawa, Hokkaido, 078-8510, Japan
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Peivandi S, Habibi MR, Baradari AG, Gholinataj A, Habibi A, Khademloo M, Foladi F. The Effect of Adding Low-Dose Naloxone to Intrathecal Morphine on Postoperative Pain and Morphine Related Side Effects after Cesarean Section: A Double-Blind, Randomized, Clinical Trial. Open Access Maced J Med Sci 2019; 7:3979-3983. [PMID: 32165939 PMCID: PMC7061398 DOI: 10.3889/oamjms.2019.852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND: Nowadays, spinal anaesthesia is a suitable choice for most elective and emergency cesarean section (C-section) deliveries. AIM: This study aimed to determine the effect of adding low-dose naloxone to intrathecal morphine on postoperative pain and morphine related side effects after C-section. MATERIAL AND METHODS: In the present double-blind, randomised clinical trial, 70 women aged over 18 years, who were candidates for elective medical C-section under spinal anaesthesia were selected and randomly assigned to either the study group or the control group. For spinal anaesthesia, 10 mg of Bupivacaine plus 100 μg of morphine was administered for all patients. However, patients in the study group received 20 µg of naloxone intrathecally; but the patients in the control group only received normal saline as a placebo. After surgery, patient-controlled analgesia (PCA) pump with paracetamol (Apotel®) was connected to each patient. The intensity of postoperative pain in the patients was evaluated and recorded using Visual Acuity Screening (VAS) at 2, 4, 6 and 24 hours after the surgery. The patients were also examined for postoperative nausea and pruritus. RESULTS: Regardless of the groups to which the patients were assigned, a significant difference in pain intensity was observed during the study period (time effect; p < 0.001). Although the intensity of pain was lower in the study group, the difference was not statistically significant (group effect; p = 0.84). Also, there was no group time interaction between pain intensity and the times studied (p = 0.61). The incidence rates of postoperative nausea and pruritus were significantly lower in the study group compared to the control group (p < 0.001). CONCLUSION: According to the results of this study, adding low dose naloxone to intrathecal morphine did not significantly change postoperative pain intensity in the patients undergone elective C-section using spinal anaesthesia; however, significantly decreased the severity of postoperative nausea and pruritus.
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Affiliation(s)
- Saloumeh Peivandi
- Department of Gynecology and Obstetrics, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Reza Habibi
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Afshin Gholipour Baradari
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdolmajid Gholinataj
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Habibi
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Khademloo
- Department of Community Medicine, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Foad Foladi
- Department of Anesthesiology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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