Intrathecal Bupivacaine with Fentanyl Versus Bupivacaine Alone for Caesarean Section Under Spinal Anesthesia

Zanyar Noori  Osman

doi:10.56056/amj.2025.334

Authors

Zanyar Noori Osman M.B.Ch.B., C.A.B.M.S., Lecturer at Kurdistan Higher Council of Medical Specialties (KHCMS) –Kurdistan–Iraq

DOI:

https://doi.org/10.56056/amj.2025.334

Keywords:

Bupivacaine, Caesarean Section, Fentanyl, Postoperative pain, Spinal anesthesia

Abstract

Background and objectives: Postoperative pain might start due to the decrement effect of anesthetic drugs. Complications are reduced and recovery hastens with post-surgical pain control. The aim of this study is to evaluate the effect of spinal anesthesia by combining drugs (Bupivacaine and Fentanyl) versus Bupivacaine alone, to manage postoperative pain.

Methods: This study is a randomized clinical trial in which sixty patients, that underwent caesarean section under spinal anesthesia at The Slemani Maternity Teaching Hospital between November 2021 and March 2022. The patients were grouped into two: 30 patients in each of group (F) that received Bupivacaine 15mg(3ml) and Fentanyl 10?g, and 30 patients in the group (B) that received Bupivacaine 15mg (3ml) only. The parameters (pain at the site of surgery, pain outside the site of surgery, pruritus outside of the surgical site and pain during the return of movement) were recorded in the post-operative periods: 30 minutes,1, 1.5, 2 and 2.5 hours.

Results: We found that the intrathecal administration of Fentanyl and Bupivacaine has decreased postoperative pain compared to Bupivacaine alone. The data showed statistically significant results in all post-operative periods: 30min (F group %13, B group %83.3), 1hour (F group %13.3, B group %93.3), 1:30hour (F group %23.3, B group %93.3), 2hour (F group %33.3, B group %96.6) and 2:30hour (F group %60, B group %100).

Conclusion: Adding Fentanyl is more effective for decreasing postoperative pain compared to Bupivacaine alone.

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