Comparison of Intensity and Duration of Analgesia as Well as Complications Addition of Intrathecal Fentanyl or Sufentanil to Bupivacaine 0.5% Hyperbaric for Spinal Anesthesia in Patients Undergoing Elective Cesarean Section

Spinal anesthesia is the most common anesthesia in cesarean section that creates a strong sensory and motor block. Fentanyl and sufentanil are among the intrathecal opiate medication that each have different side effects, and this has led to a lack of consensus on the most appropriate or dosage medication. In this study, sufentanil and fentanyl were compared with placebo.

In this clinical trial study, 120 pregnant women who were candidates for elective cesarean section and the ages between 18 and 30 years were selected. After obtaining informed consent, they were randomly divided into three groups of 40 each. The groups included bupivacaine plus 20 μg fentanyl, or 2.5 μg sufentanil, or 0.5 cc normal saline. The duration and quality of analgesia, heart rate, blood pressure, and side effects including vomiting, itching, and chills were recorded.

The mean age of patients was 29.1 ± 5.1 (P = 0.75). The mean duration of analgesia in the fentanyl and sufentanil groups was more than the placebo group (P = 0.008). There was no significant difference in analgesic quality between the three groups (P = 0.68). Postoperative nausea was significantly higher in the fentanyl group than in the other groups (P = 0.021). The itching rate in the bupivacaine group was also significantly lower than the other two groups (P = 0.018).

According to the results of this study, the use of sufentanil increases the duration of analgesia and its side effects are less than fentanyl, so in cases such as elective cesarean section it can be used to increase the duration of nerve block.