Luigi La Via, Carmelo Minardi, Serena Brancati, Sara Valenti, Simone Messina, Eugenio Garofalo, Andrea Bruni, Paolo Murabito, Renato Bernardini, Filippo Sanfilippo
In patients undergoing caesarean section (CS) with spinal anesthesia, the superiority of one intrathecal opioid over another one is not fully established. In order to investigate this, we joined the PAIN OUT Project (NCT02083835) for a two-year period. We surveyed patients undergoing elective CS with intrathecal anesthesia. Patients were asked to complete an anonymous questionnaire. Primary outcomes were: worst pain experienced, time spent in severe pain, relief received by treatment, satisfaction about pain management, wish for more pain treatment. We included 144 patients. The two main pain management combinations used were: bupivacaine-morphine (B-M, n=100) and bupivacaine-fentanyl (B-F, n=32). There were no differences in any of the primary outcomes between the groups. The B-F population received more intravenous/intramuscular opioids during the intraoperative (p<0.01) and the postoperative (p<0.001) period. The choice of morphine or fentanyl as adjunct to local anesthetic in spinal anesthesia for CS does not affect the patient’s experience with regards to pain management.
