Abstract

MELENDEZ FLOREZ, Héctor Julio; GAMARRA H, Germán; FERNANDEZ, Carlos  and  DULCEY, Ramón. Eficacia del fentanyl adicionado a bupivacaina en el dolor intraoperatorio en cesárea bajo anestesia subaracnoidea. Ensayo clínico controlado. Rev. colomb. anestesiol. [online]. 2005, vol.33, n.3, pp.161-168. ISSN 0120-3347.

The intraoperative pain in caesarean under spinal anesthesia (DIOC) is reported in up 50%.The administered opioid intrathecal (OIT) can reduce the incidence and severity if DIOC and their routine use remains controversial. In randomized controlled trial we investigated the effect of adding fentanyl to BPV. Patient received intrathecal injection of 0.5% BPV 10mgrs (group control) or BPV 7.5mgrs+15mcgrs fentanyl+0.2cc normal saline (group2) or BPV 7.5mgrs + 25mcgrs de fentanyl (group3). The DIOC was evaluated according verbal analogue scale was evaluated likewise events adverse events on the patients, neonate, and postoperative analgesia (POP). Doses of fentanyl of 15 or 25 mgrs. added to BPV diminished the DIOC one 48.92%. DIOC group1=36.59% (IC95%5.94-47.23), Group 2=12.82% (IC95%.5.23-20.41) group3=13.92% (IC95%2.45-15.26) p=0.000. The predictor model demonstrated likewise the levels between T5T6, the relative risk (RR) of DIOC =1.48 (IC95% 1.3-1.69) versus T2T4,the origin of urban area behaves as factor of risk with RR =1.76 (IC95% 1.01-3.08). and RR in group 2=0.38 (IC95%0.210.71) and group 3=0.47 (IC95% 0.250.85) versus control. The absolute risk the adverse events were more significant in the control group=81.70% (IC 95% 73.2-90.3) P=0.004. The group 3 presented best postoperative analgesia and a best evaluation of the technique P=0.000. fentanyl intrathecal 15 or 25 micrograms added to 7.5 mg of BPV heaved to 0.5% is efficacious for diminish the incidence of DIOC compared with BPV only 10 mg, with minor secondary effects, greater postoperative analgesia and evaluation technique.

Keywords : anaesthesia; obstetric; caesarean; intraoperative pain; opioid; bupivacaine; intrathecal; clinical trial.

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