Small-Dose Ropivacaine Hydrochloride with Fentanyl versus Large-Dose of Ropivacaine Hydrochloride for Cesarean Section

J Coll Physicians Surg Pak. 2019 Apr;29(4):301-304. doi: 10.29271/jcpsp.2019.04.301.

Abstract

Objective: To compare the effect of small-dose ropivacaine hydrochloride combined with fentanyl versus large-dose of ropivacaine hydrochloride for cesarean section.

Study design: Experimental study.

Place and duration of study: Department of Anesthesiology, Gansu People's Hospital, China, from February 2017 to April 2018.

Methodology: A total of 134 maternal women, who underwent cesarean section, were randomly divided into control group and observation group, with 67 cases in each group. Control group was anesthetized with a large dose (1.5 mL) of ropivacaine hydrochloride, and observation group was anesthetized with a small dose (1 mL) of ropivacaine hydrochloride in combination with 10 µg of fentanyl. Then anesthetic effects of the two groups were compared.

Results: The onset time of anesthesia and postoperative pain scores of the anesthesia in observation group were better than those in control group (both p<0.001). There was no significant difference in HR, SpO₂ and MAP between the two groups after 15 minutes of anesthesia, and after the operation (p=0.393, 0.275, 0.108, 0.740, 0.068 and 0.230, respectively). After the delivery of the fetuses, the HR, SpO₂ and MAP of the parturients in observation group were better than those in control group (all p<0.001). Frequency of adverse reactions of parturients in observation group was lower than that in control group (p=0.033).

Conclusion: In comparison to large-dose of ropivacaine hydrochloride, small-dose of ropivacaine hydrochloride combined with fentanyl, in combined spinal-epidural analgesia on parturients accepting cesarean section, can more effectively maintain their hemodynamic stability, relieve postoperative pain, and have a low incidence of adverse reactions.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Analgesia, Epidural / methods*
  • Analgesics, Opioid / administration & dosage*
  • Anesthesia, Obstetrical / methods*
  • Anesthesia, Spinal
  • Anesthetics, Local / administration & dosage*
  • Cesarean Section / methods*
  • Dose-Response Relationship, Drug
  • Female
  • Fentanyl / administration & dosage*
  • Humans
  • Pain, Postoperative / drug therapy
  • Pregnancy
  • Ropivacaine / administration & dosage*
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Anesthetics, Local
  • Ropivacaine
  • Fentanyl