Outcomes of Spinal Anesthesia for Elective Cesarean Section Using Bupivacaine Combined with Intrathecal Fentanyl

Alkaissi A^1*, Almasri N², Yahya A³

¹Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine, [email protected]

² Rafidia Hospital, Nablus, Palestine, [email protected]

³Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine, [email protected]

 

Presenter Name

Dr. Aidah Alkaissi

Abstract

Currently, there is no consensus on the optimal dose of fentanyl that should be combined with bupivacaine in spinal anesthesia for cesarean sections deliveries. This study was conducted to determine the optimal dose of intrathecal fentanyl to be combined with bupivacaine that is needed to obtain an optimal mix of sensory and motor block, analgesia, and acceptable incidence of adverse effects in spinal anesthesia for cesarean section deliveries. Methods: This was a prospective, randomized, double-blind clinical trial that was conducted in adherence to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Women who opted for elective cesarean section deliveries were randomized into 4 groups. Groups 1-3 received 7.5 mg of 0.5% hyperbaric bupivacaine with 10, 15, and 25 μg of fentanyl, respectively. Group 4 received 10 mg of 0.5% hyperbaric bupivacaine without fentanyl. Sensory and motor block, analgesia, hemodynamic stability, the incidence of adverse effects, and neonatal health outcomes were assessed. Results: A total of 160 women completed the study (40 women in each group). The women who received 25 μg of fentanyl with 7.5 mg of 0.5% hyperbaric bupivacaine had significantly shorter (p-value < 0.0001) sensory block latency, longer duration of sensory block, longer duration of analgesia, less need for rescue analgesia, expressed higher satisfaction with analgesia, experienced less hemodynamic instabilities, and experienced fewer episodes of bradycardia and vomiting compared to those who received bupivacaine alone or in combination with lower doses of fentanyl. On the other hand, more episodes of pruritus were reported when bupivacaine was combined with fentanyl compared to bupivacaine alone (p-value < 0.01).  Conclusion: The addition of fentanyl to bupivacaine in spinal anesthesia for elective cesarean section showed clinical advantages. The findings of this study demonstrated that the optimal mix of sensory block, motor block, adequate analgesia, and acceptable incidence of adverse effects can be obtained by combining 25 µg of intrathecal fentanyl with 7.5 mg of 0.5% hyperbaric bupivacaine in spinal anesthesia for cesarean section delivery. Planners of anesthesia and obstetrics care should also consider the potential incidence of pruritus.

Keywords: Bupivacaine, Cesarean section, Spinal anesthesia, Intrathecal opioids, Fentanyl, Randomized controlled trial

What will audience learn from your presentation?

1. Improved Clinical Decision-Making Use in Practice: By determining the ideal fentanyl dose to mix with bupivacaine, the audience—especially those involved in anesthesia for cesarean sections—will be able to utilize the findings to enhance patient care. Better sensory and motor block management could arise from this, which would benefit patients' results.

Impact on Work: This study offers data that anesthesiologists can use to improve the efficiency of their practices by perhaps lowering problems like hemodynamic instability and the requirement for rescue analgesia.

2. Suggestions for Future Research Use in Research: Using the study's methodology and results, academics and researchers can investigate combinations of spinal anesthesia in more detail. They may choose to expand on this research by examining different patient populations or the long-term effects of using different doses of fentanyl.

Impact on the Workforce: This study provides a solid framework for planning and carrying out clinical trials in anesthesiology, which can help grow programs in both education and research.

3. Enhanced Anesthesia Procedures

Useful Suggestion: The research offers a useful suggestion for maximizing spinal anesthesia during cesarean procedures. Anesthesia physicians and anesthetic nurses can streamline their protocols and minimize side effects while optimizing analgesic benefits by determining the ideal dose of fentanyl.

Impact on Work: Anesthesia professionals can increase patient satisfaction and surgical efficiency by fine-tuning their dosing techniques.

4. Contribution to Teaching with Educational Content: The results offer current information on optimal techniques for spinal anesthesia during cesarean sections and can be included into anesthesia and obstetrics teaching programs.

Impact on the Workplace: Teachers can use this research to improve their lesson plans by providing trainees and students with evidence-based recommendations that will help them grasp and apply spinal anesthetic procedures more effectively.

5. Possibility of Cross-Disciplinary Collaboration

Greater Effect: The results of the study may encourage anesthesiologists, obstetricians, and nursing staff to work together to create comprehensive care plans that consider the requirements of both obstetricians and anesthesiologists.

Impact on Work: Patients and healthcare providers alike could gain from this interdisciplinary approach's potential to simplify care, lower complications, and enhance overall outcomes for cesarean deliveries.

Conference Title

https://worldnursing.scientifink.com/wp-content/uploads/2024/08/Nursing-Dubai-2025_Brochure.pdf

Conference Country

United Arab Emirates

Conference Date

April 28, 2025 - April 30, 2025

Conference Sponsor

university

Additional Info

Conference Website