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

Abstract

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 μg 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)).