The effect of fentanyl and nalbuphine used as analgesics in balanced anesthesia were evaluated in 60 full term parturients, ASA physical status class I or Ⅱ, sheduled for elective cesarean section.
They were injected intramusculary with 0.2 mg of glycopyrrolate 30 minutes to one hour prior to the induction of anesthesia. Four mg/kg of thiopental sodium and one mg/kg of succinylcholine were administered intravenously for the induction and
endotracheal intubation. Anesthesia was maintained with 66% of nitrous oxide in oxygen until delivery.
Following the intravenous injection of 4 mg-vecuronium, controlled ventilation was applied to maintain at PCO2 30 to 40 mmHg.
Immediately after clamping of the umbilical cord, 3 (g/kg of fentanyl(F group) or 0.3mg/kg of nalbuphine(N group)with 5 mg of droperidol were administered.
In the F group, the systolic and diastolic blood pressures at three minutes after fentanyl were significantly lower than those during the preinduction period and during recovery room stay. The systolic BP in the preinduction period was
significantly
higher than those of three minutes after nalbuphine, and the diastolic BP at the preinduction periold was also higher than those of thee minutes after nalbuphine and during recovery room stay. Heart rates were significantly increased three
minutes
after
nalbuphine than at recovery room. The blood pressures and heart rates were not significantly different between the two groups.
The time intervals from the end of the operation to the first analgesics were significantly longer in the N group(mean 11.3 hours) in contrast to the Fgroup(mean 6.9 hours).
There were a few complications such as nausea, headache, dizziness, somnolence and euphoria. The incidences of awareness was 13.3 and 6.7% in the F and Ngroup, respectively.
We concluded that the balanced anesthetic technique using nalbuphine with droperidol nuder the inhalation of 66%-nitrous oxide resuited in a satisfactory anesthesia for cesarean section with good postoperative analgesia.
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