Abstract
Background and Objectives: Intrathecal injection of opioids has been introduced to improve analgesia and decrease of hemodynamic instability due to sympathetic blockade of local anesthetics during spinal anesthesia.There is a little information regarding effects of the intrathecally administered opioids on the fetus and of possible adverse neonatal effects of preeclamptic parturients. This study designed to evaluate neonatal effects of adding fentanyl to small-dose lidocaine for spinal anesthesia in severe preeclamptic parturients undergoing cesarean section.
Methods and Materials: Sixty parturient's with severe preeclampsia scheduled for cesarean section were allocated in this double-blind, and case-controlled trial. Thirty patients received 50 mg lidocaine 5% with 10 µg fentanyl (study group) and in the other 30 patients 100mg lidocaine 5% was used (control group). Apgar scores and umbilical artery acid-base values were recorded. Maternal blood pressure and quality of analgesia during surgery were recorded.
Results: There were no statistically significant with regard to neonates Apgar scores at 1 (7.80±1.34 in study group and 7.90±1.15 in control group; p=0.759) and 5 minutes after birth (8.70±0.46 in study group and 8.83±0.37 in control group; p=0.229). Umbilical artery pH values did not differ between two groups. There was statistically significant fall in blood pressure in control group than the study group (63.33% vs 20% respectively; p<0.0001). Pain and discomfort during surgery were experienced more frequently in control group (83.33%) than the study group (16.66%; p<0.0001).
Conclusion: Adding of fentanyl to small-dose of lidocaine during spinal anesthesia in severe preeclamptic patients undergoing cesarean section did not produce neonatal side effects. This combination improved the quality of anesthesia.