Prevalence of pruritus following Intrathecal fentanyl and sufentanil after spinal anesthesia in cesarean section

Intratechal opioids in combination with local anaesthetic drugs are commonly used for analgesic induction during cesarean section. Lipophilic opioids such as Fentanyl and Sufentanil are among most commonly used intratechal opioids. Pruritus is one of the most common complications of opioids. So, this study was performed with aim to compare the frequency and severity of pruritus following intratechal administration of fentanyl or sufentanil with Bupivacaine in elective cesarean section.

This double-blind randomized clinical trial study was performed in 2019 on 50 pregnant women candidate for elective cesarean section and referred to Shahid Mostafa Khomeini hospital in Tehran. The subjects were randomly divided into two groups. One group received 25 microgram intratechal fentanyl and another group received 2.5 microgram sufentanil both in combination with 12.5 miligram hyperbaric bupivacaine 0.5%. After the surgery, data about age, BMI, surgery duration and pruritus were evaluated. Data were analysed by SPSS software (version 21) and Chi-square and Independent t-test. P<0.05 was considered statistically significant.

There was no significant difference between the two groups in terms of age (P=0.428), BMI (P=0.339) and surgery duration (P=0.296). Frequency of pruritus was 68% in fentanyl and 88% in sufentanil groups; this difference was not statistically significant (P=0.088). Pruritus severity (P=0.361) and use of anti-pruritus drug (P=0.333) showed no significant difference between the two groups.

Pruritus is a common side-effect of intratechal fentanyl and sufentanil. There was no evidence in favour of higher prevalence of pruritus in the sufentanil group than the fentanyl group.