Canadian Journal of Anesthesia, Vol 32, 502-505, Copyright © 1985 by Canadian Anesthesiologists' Society

Epidural Fentanyl, With and Without Epinephrine for Post-Caesarean Section Analgesia

¹ Department of Anaesthesia, University of British Columbia and Grace Hospital, Vancouver, British Columbia

Address correspondence to: Dr. G.H. McMorland, Department of Anaesthesia, Grace Hospital, 4490 Oak Street, Vancouver, British Columbia, V6H 3V5.

Using a double-bolus technique, the efficacy and safety of epidural fentanyl with and without epinephrine 1:400,000 for post-Caesarean section analgesia was examined in 30 patients. The addition of 25 µg epinephrine to the fentanyl (100 µg) did not potentiate the speed of onset but did significantly prolong the duration of action of the second dose. The only side effect encountered was pruritus, which was significantly increased (from 17-44 per cent) when epinephrine was added. The results indicate a clinical advantage of prolonging the duration of action of fentanyl for post-Caesarean Section analgesia with the addition of epinephrine, but the cumbersome and time-consuming nature of a double-bolus technique limits its clinical value. The relative safety of epidural fentanyl with and without epinephrine was confirmed by the absence of respiratory depression, drowsiness or hypotension in all patients.

Key Words: PAIN: postoperative • ANALGESICS: narcotic • ANAESTHETIC TECHNIQUES: epidural