Intrathecal fentanyl added to hyperbaric ropivacaine for cesarean delivery.

BACKGROUND AND OBJECTIVES: Hyperbaric ropivacaine produces adequate spinal anesthesia for cesarean delivery. Addition of opioid to local anesthetics improves spinal anesthesia. We assessed the effect of fentanyl added to hyperbaric ropivacaine for spinal anesthesia for cesarean delivery.

METHODS: Fifty-nine healthy, full-term parturients scheduled for elective cesarean delivery under spinal anesthesia were randomly assigned in a double-blind fashion to receive either fentanyl 10 micro g or normal saline 0.2 mL added to 0.5% hyperbaric ropivacaine 18 mg. Characteristics of spinal block, intraoperative quality of spinal anesthesia, side effects, complete analgesia (time to first feeling of pain), and effective analgesia (time to first request of analgesics) were assessed.

RESULTS: Duration of sensory block was prolonged in the fentanyl group (P <.05). Duration of motor block was similar in both groups. The quality of intraoperative analgesia was better in the fentanyl group (P <.05). Incidence of side effects did not differ between groups. Duration of complete analgesia (143.2 +/- 34.2 minutes v 101.4 +/- 21.4 minutes; P <.001) and effective analgesia (207.2 +/- 32.2 minutes v 136.3 +/- 14.1 minutes; P <.001) were prolonged in the fentanyl group.

CONCLUSIONS: Adding fentanyl 10 micro g to hyperbaric ropivacaine 18 mg for spinal anesthesia for cesarean delivery improves intraoperative anesthesia and increases the analgesia in the early postoperative period.