Effect of epinephrine on intrathecal fentanyl analgesia in patients undergoing postpartum tubal ligation

• Published in: Anesthesiology (Philadelphia) Vol. 73; no. 3; pp. 381 - 385
• Main Authors: MALINOW, A. M, MOKRISKI, B. L. K, NOMURA, M. K, KAUFMAN, M. A, SNELL, J. A, SHARP, G. D, HOWARD, R. A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01-09-1990
• Subjects: Adult; Anesthesia, Spinal; Anesthetics. Neuromuscular blocking agents; Biological and medical sciences; Double-Blind Method; Epinephrine - administration & dosage; Epinephrine - pharmacology; Female; Fentanyl; Humans; Injections, Spinal; Lidocaine - administration & dosage; Lidocaine - pharmacology; Medical sciences; Neuropharmacology; Pain, Postoperative - prevention & control; Pharmacology. Drug treatments; Population; Postpartum Period; Randomized Controlled Trials as Topic; Sterilization, Tubal; Human; Epinephrine; Drug combination; Opiates; Narcotic analgesic; Catecholamine; Intrathecal administration; Analgesia; Regional anesthesia; Surgery; Local anesthesia; Sterilization; Female; Woman; Data Collection; Pruritus; Family Planning; Puerperium; Research Methodology; Dermatitis; Tubal Ligation; Diseases; Postpartum Women; Studies; Reproduction; Tubal Occlusion; Analgesia > analysis; Treatment; Female Sterilization; Double-blind Studies; Anesthesia > administraction and dosage; Population Characteristics; Data Analysis; Population; Sterilization, Sexual; Demographic Factors
• ISSN: 0003-3022; 1528-1175
• DOI: 10.1097/00000542-199009000-00003

Eighty women receiving spinal anesthesia for postpartum tubal ligation were entered into a double-blind, randomized protocol studying the effects of epinephrine on intrathecal fentanyl-induced postoperative analgesia. All patients received 70 mg hyperbaric lidocaine with either 0.2 mg epinephrine (LE), 10 micrograms fentanyl (LF), epinephrine and fentanyl (LFE), or 0.4 ml saline (L). Onset and regression of anesthesia, degree of intraoperative comfort, incidence of pruritus, and extent of postoperative analgesia were evaluated. The simultaneous administration of epinephrine and fentanyl prolonged the duration of complete analgesia (137 +/- 47 min (LFE); 76 +/- 32 min (LE); 85 +/- 44 min (LF); 65 +/- 36 min (L)) and the duration of effective analgesia (562 +/- 504 min (LFE); 227 +/- 201 min (LE); 203 +/- 178 min (LF); 198 +/- 342 min (L)). Administration of epinephrine decreased the incidence of pruritus associated with intrathecal fentanyl (1/18 (LFE); 1/21 (LE); 8/19 (LF); 2/19 (L)).