جستجوی مقالات مرتبط با کلیدواژه « : فنتانیل » در نشریات گروه « پزشکی »

Introsuction:

 Itching is one of the main side effects of intrathecal opioids administration. In the present study, prevalence of itching following intrathecal fentanyl administration and its related factors have been investigated in adult patients who were candidates for lower extremity surgeries.

320 patients had participated in the study. Spinal anesthesia was done in a standard setting with a combination of bupivacaine and fentanyl. After confirming and stabilizing block height patients were provided sedation with 1-2mg intravenous midazolam. A nurse anesthetist then collected data regarding pruritis and its severity if applicable.

Itching was reported in 84 patients (27%) with a mean severity score of 4.94. Of the 84 patients who reported pruritus, 70 were in need of treatment. The severity of itching was significantly higher in men than in women (P=0.029). None of the indicators of severity and prevalence of itching had a significant relationship with the BMI of the patients (P>0.05). The average age of patients in whom itching was reported was significantly lower than the age of other patients (P=0.044).

Our results showed that the intensity of itching is significantly higher in men. Moreover, the incidence of itching was also higher in younger patients.

this anesthesia method is associated with side effects such as nausea, vomiting and itching; Therefore, this study was conducted with the aim of determining the effect of different doses of intrathecal fentanyl on the quality and quantity of pain-free time in cesarean section of multiparous mothers.This randomized clinical trial study was conducted on 60 pregnant women who volunteered for multiple elective caesarean section with spinal anesthesia. In this study, subjects were randomly divided into two treatment groups (bupivacaine and fentanyl (with doses of 15 and 25 micrograms)) and were finally analyzed by SPSS version 26 statistical software.The maximum level of sensory block in the 25 micrograms fentanyl group was significantly higher than the 15 micrograms fentanyl group. The maximum recovery time of motor block in the 15 micrograms fentanyl group was significantly higher than the 25 micrograms fentanyl group. The complication of vomiting in the 15 micrograms group was significantly higher than the 25 micrograms group, however, the onset time of sensory block, the maximum degree of sensory block, the quality of anesthesia during surgery, the duration of surgery, the patient's vital signs during surgery, and anesthesia complications such as itching and nausea had no statistically significant difference between the two studied groups.it can be stated that the treatment with bupivacaine and fentanyl (with doses of 15 and 25 micrograms) did not have a statistically significant difference in anesthesia indicators and anesthesia complications (except the maximum level of sensory block, maximum recovery time and vomiting complication)

Regional anesthesia with mild effects on vital organs is a common method of anesthesia that increases the competence of surgery. This study aimed to investigate the effects of adding magnesium, neostigmine, and fentanyl to ropivacaine alongside placebo on motor-sensory block properties in lower extremity surgeries under spinal anesthesia.

This current triple-blind clinical trial study was conducted on 100 patients who were candidates for lower limb surgery at Kashani Hospital in Isfahan during 2020-2021. These patients were randomly divided into four groups of 25 cases: Group1: ropivacaine plus fentanyl, Group2: ropivacaine plus magnesium sulfate, Group3: ropivacaine plus neostigmine and in the fourth group: ropivacaine plus 5% sugar solution that was injected into the cerebrospinal fluid space from L3-L4. The time of activity initiation and duration of sensory and motor block, and the maximal block height were recorded in all groups. Also, pain during recovery and the occurrence of common complications such as nausea, vomiting, hypotension) were evaluated and analyzed.

There is no significant difference between all groups in terms of the time interval between injection and motor block, sensory motor return, sensory block, and maximal block height and frequent distribution of nausea, vomiting, and hypotension. The shortest time interval between drug injection and sensory block occurred in ropivacaine plus fentanyl group. At the same time, the shortest length of stay in recovery was observed in the placebo group with ropivacaine. The lowest pain intensity was significantly recorded between 30 and 60 minutes of recovery in the fentanyl and neostigmine group compared to the other three groups.

Fentanyl, magnesium sulfate, neostigmine, along with ropivacaine, improved the onset of regional anesthesia with better anesthetic quality, but increased recovery time by reducing the consumption of analgesics compared to placebo. However, it seems that according to these data, a combination of ropivacaine with fentany in spinal anesthesia could be a better alternative for inducing a faster sensory block and controlling pain.

Appropriate drug regimen during colonoscopy is one of the matters of concern in anesthesia. This study was conducted to compare the efficacy of propofol-ketamine combination and propofol-fentanyl in colonoscopy.

In a single-blind randomized clinical trial, 200 patients aged 18-60 years candidate for colonoscopy, were randomly allocated into two groups to receive either fentanyl-propofol (PF) or ketamine-propofol (PK) using block randomization. Recovery time (end of injection until Steward Score was 6) as the primary outcome and vital signs, complications, total dose of propofol, and satisfaction of the doctor performing the colonoscopy as secondary consequence were compared between the two groups.

Recovery time was 2.97 ± 0.89 min in the fentanyl-propofol group and 8.84 ± 1.73 min in ketamine-propofol group (P<0.001). Systolic and diastolic blood pressure and heart rate significantly decreased in the fentanyl-propofol group compared with the other group (P <0.001) which was persistent until five minutes after colonoscopy. Restlessness was seen in 28 patients receiving propofol-ketamine but no patient in fentanyl-propofol group developed this condition (P <0.001). Satisfaction of the doctor performing the colonoscopy and propofol dose were significantly better in patients that received ketamine-propofol (P<0.05).

Fentanyl-propofol combination was associated with faster recovery time and less restlessness than the ketamine-propofol compound, but the latter combination is recommended as it led to better hemodynamic stability, greater satisfaction of the doctor, and reduced dose of propofol.

two drugs, fentanyl and sufentanil, are drugs added to the anesthetic trial, which have been used more than other drugs, however, there is still no detailed information about the safety of adding these two drugs to the anesthetic drug in the event of urinary retention in Therefore, the present study was conducted with the aim of comparing the addition of fentanyl and sufentanil to the anesthetic drug and its effects on urinary retention after spinal anesthesia.

This study was conducted as a systematic review and meta-analysis based on the PRISMA statement. Searching MEDLINE, CENTRAL and EMBASE, Web of Science, Scopus, Mag Iran and SID databases using the keywords anesthesia, spinal anesthesia, phenethyl, sufentanil, bupivacaine, ropicaine, levobopiva, regional anesthesia, urinary retention and after Anesthesia was performed with the help of Boleyn operatives.

There was no significant difference in urinary retention (RR=1.02 [0.70-1.49]; 95% CI) between the intervention and control groups; Also, there was no significant difference between fentanyl or sufentanil (Chi=0.13/I=0%).

Adding fentanyl or sufentanil to the anesthetic drug during spinal anesthesia has no effect on urinary retention after surgery

Nausea and vomiting after surgery is a relatively common complication that despite advances in prevention and treatment is still the most problematic side effect observed in the recovery room and after surgery. The study aimed to evaluate the effect of adding dexmedetomidine and fentanyl to bupivacaine on nausea and vomiting in patients undergoing orthopedic lower extremity surgery with spinal anesthesia.

This randomized double-blind clinical trial study was performed on 40 patients aged 18 to 50 years with anesthesia classes (ASA I, II) who were candidates for lower limb orthopedic surgery (femur). Patients were randomly divided into two groups: 1: (12.5 mg bupivacaine (2.5 ccs) and 10 mg fentanyl) and group 2: (12.5 μg bupivacaine and 5 μg dexmedetomidine). At recovery times, 6, 12, and 24 hours after surgery; Patients' nausea and vomiting were assessed.

The results of the Chi-square test showed that there was a significant difference between the groups of bupivacaine-dexmedetomidine and bupivacaine-fentanyl in terms of nausea and vomiting only 6 hours after surgery (P=0.034). At 6 hours postoperatively, the frequency of nausea and vomiting in patients in the bupivacaine-fentanyl group (50%) was higher than in the bupivacaine-dexmedetomidine group (25%).

Although in most minutes of the study, there was no significant difference between the two groups in terms of vomiting nausea, at 6 hours after surgery, there was a significant difference between the bupivacaine-dexmedetomidine and bupivacaine-fentanyl groups in terms of nausea. In addition to its analgesic effects, dexmedetomidine appears to prevent nausea and vomiting in patients after surgery.

In patients undergoing surgery, hemodynamic disorders are common. Therefore, we decided to compare the effects of fentanyl and dexmedetomidine on hemodynamic changes in patients undergoing Stereotactic surgery. 

In this double blinded clinical trial, 68 candidates for Stereotactic Surgery in Alzahra Hospital in 2017 enrolled in the study. Patients were randomly divided into two groups; the first group was given bolus of 2 μg / kg fentanyl, and in the second group a loading dose of 1 μgr / kg / 10 min, followed by maintenance dose of: 0.5 μg / kg / h of dexmedetomidine was admininstered intravenously. The Dexmedetomidine was infused immediately following anesthesia induction. The hemodynamic variables in the two groups were evaluated.

There was no significant difference between the two groups based on systolic and diastolic blood pressure and oxygen saturation at different times. The heart rate in the dexmedetomidine group at 30, 60 and 90 minutes was significantly lower than fentanyl. On the other hand, there was no significant difference between the two groups with regards to pH, Pco2 and HCO3 before and after operation and recovery time.

Both dexmedetomidine and fentanyl are two effective drugs for controlling hemodynamics parameters in patients undergoing stereotactic surgery, but dexmedetomidine drug reduces heart rate significantly compared with fentanyl.

The aim of this study was to evaluate the effects of preventive administration of ketamine, fentanyl and paracetamol on pain intensity and hemodynamic parameters after deep vitrectomy.

In this clinical trial, 80 candidates of deep vitrectomy surgery were randomly assigned into 4 groups (1-4) and received 0.5 mg / kg ketamine, 2 μg / kg fentanyl, 10 mg/kg of paracetamol and equivolume of normal saline respectively intravenous infusion during the last 15 minutes of surgery. Pain intensity and hemodynamic parameters were recorded and analyzed.

Pain intensity was significantly higher in placebo group during the first 4 hours after operation (p<0.01), but no significant differences were observed between the study groups at 8 and 24 hours after operation in this regard. There were no significant differences between the three intervention groups in terms of pain intensity during the study. Also there were no significant differences between the 4 study groups regarding to hemodynamic parameters.

The use of each of the three intervention drugs significantly reduced the pain intensity compared to the control group without any hemodynamic derangement.

Dexmedetomidine is a new sedative that has analgesic and sympatholytic effects. This study was performed to compare the hemodynamic response of dexmedetomidine and fentanyl after endotracheal intubation in lumbar spine surgery.

In a double-blind clinical trial, 80 patients aged 20-65 years candidates for elective spinal surgery were randomly divided into two groups to receive either dexmedetomidine or fentanyl. In case group, dexmedetomidine (0.5 mcg/kg) and in control group fentanyl (1 mcg/kg in 50 ml of normal saline) were administered 10 minutes before endotracheal intubation. Heart rate and mean arterial pressure were measured at 1, 3, 5, and 10 minutes after intubation. Endotracheal intubation quality and first time of postoperative pain were also measured using Copenhagen score and numerical rating scale, respectively.

Heart rates at 1, 3, 5, and 10 minutes after intubation were 77.60±8.29, 75.73±8.12, 76.44±9.62, and 76.43±7.87 in dexmedetomidine group and 82.7±11.31, 82.08±10.91, 79.93±10.0, and 74.28±14.04 in fentanyl group, respectively (P˂0.001). Mean arterial pressure at 1, 3, 5, and 10 minutes after intubation were 87.45±18.68, 82.25±13.78, 81.78±13.77, and 79.13±14.81 in dexmedetomidine group and 94.95±19.40, 92.23±17.51, 88.28±15.20, and 83.18±13.43 in fentanyl group, respectively (P˂0.001). Quality of intubation was not found to be significantly different between the two groups (P= 0.10). The mean of first time postoperative pain was 9.34±7.11 minutes in fentanyl group and 13.66±10.21 minutes in dexmedomidine group (P= 0.03).

This study showed that hemodynamic changes after endotracheal intubation were less in patients who received dxmedetomidine compared to those that received fentanyl.

The prevalence of postoperative urinary retention is between 5% and 70%, depending on the type of surgery, the type and combination of anesthetics, and the patient's underlying conditions. Studies have shown that reducing the dose of local anesthetics in spinal anesthesia and the use of the drug combination reduces the incidence of urinary retention and the need for postoperative catheterization. This study was designed to evaluate the effect of adding fentanyl to spinal anesthesia on the incidence of postoperative urinary retention.

In a randomized clinical trial, patients who were candidates for lower limb orthopedic surgery or lower abdominal surgery under spinal anesthesia were enrolled. Patients with a history of urinary problems were not included. participants were excluded if a change in the method of anesthesia was intended, urinary catheterization required or urinary tract trauma occurred. Patients were randomly allocated to either spinal anesthesia with Bupivacaine 2-2.5 ml or spinal anesthesia with Bupivacaine 1.5-2 ml plus fentanyl 25 µg. Postoperative urinary retention was assessed based on the need for catheterization or a complaint of difficult or incomplete urination.

There was a significant borderline association between the complaints of incomplete (20 vs. 12 patients) or difficult urination (16 vs. 8 patients) after surgery and the addition of fentanyl to the spinal anesthesia. (P=0.05) There was no statistically significant relationship between the need for postoperative catheterization and the addition of fentanyl to the spinal anesthesia (20 vs. 13 patients; p=0.11). Logistic regression analysis showed that age and amount of fluid intake during surgery were independent predictors of difficult urination.

Adding fentanyl 25µg to local anesthetics in spinal anesthesia will increase the incidence of postoperative urinary retention. The use of lower doses of fentanyl in combination with various local anesthetic drugs in spinal anesthesia is recommended in future studies.

The risk of anesthesia increases with age, so it is necessary to choose a safe and effective method. In this study, we compared the effectiveness of intranasal fentanyl with intravenous fentanyl in patients undergoing cataract surgery.

This study was a triple-blind prospective randomized clinical trial (The patient, physician, and data analyzer were unaware of the patient grouping). The study was performed from April 2017 to March 2019 in Feyz Hospital, Isfahan, Iran. 90 patients over 18 years of age who were candidates for cataract surgery were included in the study and were divided in two groups receiving intravenous fentanyl (IVF) or intranasal fentanyl (INF). The dose of fentanyl in both groups was 1.5 μg/kg with a maximum of 100 μg. In the IVF group, 1 ml of normal saline was dripped into each nasal passage 10 minutes before surgery and intravenously fentanyl was injected 2 minutes before surgery. In the INF group, 1 ml of fentanyl was administered into each nostril 10 minutes before surgery and 2 ml of saline was administered intravenously two minutes before surgery.

In this study, there was no significant difference between the two groups in terms of mean heart rate (P=0.762), mean arterial blood oxygen saturation (P=0.262), mean systolic blood pressure (P=0.264), mean arterial blood pressure (0.462), satisfaction rate Patient (P=0.231), duration of surgery (P=0.612) and pain intensity (P=0.87). But in the intravenous fentanyl group (IVF), the level of sedation (P=0.002) and the level of surgeon satisfaction (P<0.001) were higher than intranasal fentanyl group (INF). There was no significant difference between the two groups in terms of side effects (P=0.171) and surgery time (P=0.612). The mean VAS was not significantly different between the two groups.

The study showed that intranasal administration of fentanyl compared with intravenous administration of fentanyl provided similar sedation and cardiovascular response. Intranasal administration of fentanyl is a non-invasive, safe and effective method, that is easy to use and can be a viable alternative to intravenous administration.

Intratechal opioids in combination with local anaesthetic drugs are commonly used for analgesic induction during cesarean section. Lipophilic opioids such as Fentanyl and Sufentanil are among most commonly used intratechal opioids. Pruritus is one of the most common complications of opioids. So, this study was performed with aim to compare the frequency and severity of pruritus following intratechal administration of fentanyl or sufentanil with Bupivacaine in elective cesarean section.

This double-blind randomized clinical trial study was performed in 2019 on 50 pregnant women candidate for elective cesarean section and referred to Shahid Mostafa Khomeini hospital in Tehran. The subjects were randomly divided into two groups. One group received 25 microgram intratechal fentanyl and another group received 2.5 microgram sufentanil both in combination with 12.5 miligram hyperbaric bupivacaine 0.5%. After the surgery, data about age, BMI, surgery duration and pruritus were evaluated. Data were analysed by SPSS software (version 21) and Chi-square and Independent t-test. P<0.05 was considered statistically significant.

There was no significant difference between the two groups in terms of age (P=0.428), BMI (P=0.339) and surgery duration (P=0.296). Frequency of pruritus was 68% in fentanyl and 88% in sufentanil groups; this difference was not statistically significant (P=0.088). Pruritus severity (P=0.361) and use of anti-pruritus drug (P=0.333) showed no significant difference between the two groups.

Pruritus is a common side-effect of intratechal fentanyl and sufentanil. There was no evidence in favour of higher prevalence of pruritus in the sufentanil group than the fentanyl group.

Spinal anesthesia is the most common method of analgesia for elective cesarean section. Nausea and vomiting in the patients can cause problem during the surgery. This study was performed with aim to compare the frequency of nausea and vomiting following spinal anesthesia using the drug combination of Bupivacain-Fentanyl and Bupivacain-Sufentanil in cesarean surgery.

This double-blind clinical trial study was performed in 2013 on 60 patients with term pregnancies who were candidate for cesarean under spinal anesthesia. Group F received 25 µg fentanyl while group S received 2.5 μg Sufentanil with 12.5mg intratechal Bupivacaine. The main complications were nausea and vomiting during and in the hours 1, 2 ,6, 12 and 24 after the surgery. Other investigated complications included hypotension, urinary retention and time of sensory block regression to the level of T8. Data were analyzed by SPSS software (version.16), and Chi-square test and Student t-test, Logistic regression and repeated data logistic. p < 0.05 was considered statistically significant.

The two groups were not significantly different in terms of rate of nausea (P=0.395) and vomiting during (P=0.5) and in hours 1, 2, 6, 12 and 24 after the surgery, hypotension (P=0.589), heart rate changes (P=0.105), urinary retention, the time of sensory block to T8 (P=0.556) and the time of returning motor block (P=0.787).

Using two medications of Fentanyl and Sufentanil in combination with hyperbaric Bupivacain had no impact on the frequency and prevalence of nausea and vomiting.

One of the most common complications after intrathecal anesthesia is chills during surgery. The second most common complaint followed by intrathecal anesthesia is nausea and vomiting. The aim of this study was to evaluate the effect of adding fentanyl to bupivacaine on chills and vomiting nausea in patients undergoing femoral surgery

This randomized double-blind clinical trial study was performed on 40 patients aged 18 to 50 years with anesthesia classes 1 and 2 who were candidates for femoral orthopedic surgery. Patients were randomly divided into two equal groups. The intervention group received 12.5 mg bupivacaine (2.5 cc) and 10 mg fentanyl (control group) and the control group received 12.5 μg bupivacaine (0.5 ml normal). Patients with dry mouth, nausea, vomiting and shivering were evaluated at 1, 2, 6, 12 and 24 hours after surgery. Data analysis was performed using SPSS software version 21 and descriptive and inferential statistical tests.

Forty patients undergoing spinal orthopedic surgery with spinal anesthesia participated in two equal groups (bupivacaine-fentanyl (n = 20) and bupivacaine (n = 20). There was no significant difference between fentanyl and bupivacaine in terms of recovery from nausea and postoperative times (p> 0.05) and differences between bupivacaine-fentanyl and bupivacaine in shivering at 6, 12, 18 and 24 hours postoperatively. There was no significant (p> 0.05).

In the present study, although fewer complications such as shivering and nausea and vomiting were reported within minutes of the study in the fentanyl group, this decrease was not statistically significant.

The present study aimed to evaluate the sensory-motor changes in patients undergoing lower limb orthopedic surgery with spinal anesthesia by two drug combinations of ropivacaine plus dexmedetomidine and ropivacaine plus fentanyl.

In a clinical trial study, 90 patients underwent lower extremity orthopedic surgery with spinal anesthesia were selected and randomly allocated in three groups of 30. In the first group, 4.5 ml of ropivacaine 0.5% isobaric plus 5 micrograms of dexmedetomidine in 0.5 cc of distilled water, in the second group, 4.5 cc of isobaric ropivacaine plus 25 micrograms of fentanyl in 0.5 cc distillated water, and in the third group, 4.5 ml ropivacaine 0.5% isobaric in 0.5 cc distillated water was injected. The severity of pain and sensory and motor characteristics of patients were determined and compared between the three groups.

The mean time of onset of sensory motor block in the three groups of ropivacaine-dexmedetomidine, ropivacaine-fentanyl and ropivacaine alone was 9.1 ± 3.0, 11.2 ± 3.2, and 12.5 ± 4.3 minutes, respectively (P = 0.001). The mean time of motor block in the three groups was 10.9 ± 3.3, 14.7 ± 5.1, and 15.8 ± 4.8 minutes, and this time was shorter in the groups of ropivacaine-dexmedetomidine (P < 0.001).

The onset of sensory and motor block was shorter in the ropivacaine-dexmedetomidine group.

Postoperative shivering is one of the common complications of surgery in the recovery room, with an incidence rate of about 50-60% in various reports. Postoperative chills usually result in unwanted hypothermia during operation.

In this study, patients were divided randomly (after selecting one of 32 card containing coatings) into intervention group (n=45) and the placebo group (n=45). This was done by anesthesiologist who had no intervention in the study, and anesthesiologist and patients did not receive information about the drugs received and the examination of chills and severity of chills was performed by a person who was not aware of the way of study.

There was a significant difference in the frequency of shivering between the intervention group (fentanyl) and the placebo group (without fentanyl) (p <0.001). There was no significant difference regarding severity of shivering between the intervention group and the placebo group (p = 450.0). There was no significant difference in vomiting between the intervention group and the placebo group (p=.184). There was a significant difference between the intervention group and the placebo group (p = 0.003) with regard to nausea. Because vomiting was only recovered in the placebo group (without fentanyl), there were 2 patients and in the intervention group (fentanyl), vomiting was not recovered at all. Therefore, no significant difference was observed regarding frequency of vomiting between the intervention group and the placebo group. There was no significant difference in the vomiting time between the intervention group and the placebo group (p = 0.69). There was a significant difference between the intervention group and the placebo group regarding pruritus (p <0.001).

Most of the patients who received fentanyl had less shivering during surgery and recovery than those who did not receive fentanyl, and most of the patients who received fentanyl had less nausea during operation and recovery than those who did not receive fentanyl and those who received fentanyl have had more pruritus during operation and recovery than those who did not receive fentanyl. Also, taking fentanyl is effective in itching during surgery and recovery.

Cataract is one of the most common eye diseases especially in elderly patients and most of these patients require surgery. In the process of sedation, different drugs are used, each with its advantages and disadvantages. Dexmedetomidine is one of the drugs that has recently received special attention for sedation. In this study, we compared the drug combination of dexmedetomidine-fentanyl with midazolam-fentanyl in cataract surgery.

In a case-control study, the patients who underwent cataract surgery by a surgeon with topical anesthesia and sedation techniques were included in the target group. Seventy patients were divided into two groups of 35 according to a random number table. One group received dexmedetomidine-fentanyl (dexmedetomidine group) and the other received midazolam-fentanyl (midazolam group). Age, sex, weight, systolic and diastolic blood pressure, heart rate, patient sedation, surgeon satisfaction, recovery nurse satisfaction, and postoperative nausea and vomiting were compared between the two groups. The study was performed in the Farabi Hospital, Tehran, Iran, from October to November 2019.

Patients in the two groups were similar in age, sex, weight, and preoperative hemodynamic variables. There was no significant difference in preoperative systolic and diastolic blood pressure between the two groups (P=0.150). However, those who received dexmedetomidine had significantly lower intraoperative heart rate (P<0.001). The difference in postoperative systolic and diastolic blood pressure as well as postoperative heart rate was significantly lower in the dexmedetomidine group (P<0.001). There was no statistically significant difference between the two groups in postoperative sedation (P=0.93). The surgeon’s satisfaction was no significant difference between the two groups (P=0.17). Also, the rate of recovery nurse satisfaction was not significantly different between the two groups (P=0.21). The incidence of nausea and vomiting was similar in both groups (P=1.00).

Sedation with dexmedetomidine decreases blood pressure and heart rate. Therefore, it is recommended to use dexmedetomidine more cautiously in patients with unstable hemodynamics and especially in short surgical procedures.

Opioid analgesics cause bradycardia and respiratory depression.  The aim of this study was to investigate the efficacy of diclofenac suppository on pain and dose reduction of injectable fentanyl in patients undergoing colonoscopy.

In a clinical trial, 500 patients undergoing colonoscopy were randomly divided into two groups to receive either diclofenac or glycerin (placebo) administered 30 min before colonoscopy. Five minutes before colonoscopy, fentanyl (50 μg/iv) was administered, and then, if pain persisted during colonoscopy, fentanyl 50 μg was administered as a rescue. Baseline demographic and clinical data and other information, including cecal arrival time, patients’ and gastroenterologist’s satisfaction, pain intensity based on visual analogue scale (VAS), rescue dose of fentanyl, frequency of hypotension and apnea were compared between the two groups.

The groups were similar in age, sex, and baseline clinical parameters (P> 0.05). Cecal arrival time was shorter in the group that received diclofenac (10.59±3.8 min) than the placebo group (12.41±2.5 min) (P= 0.035). Mean pain score was found to be lower in diclofenac group (3.2±54.2) than the placebo group (5.10±2.8) (P <0.0001). Frequency of fentanyl administration in diclofenac group (6%) was lower than that in placebo group (24.8%) (P <0.0001). Frequency of hypotension and apnea events were observed to be lower in the group that received diclofenac (P< 0.05).

In this study, diclofenac suppository had positive effects on reducing the pain intensity, the dose of fentanyl, and side effects, therefore, it is recommended in colonoscopy analgesia protocols.

Spinal anesthesia is the most common anesthesia in cesarean section that creates a strong sensory and motor block. Fentanyl and sufentanil are among the intrathecal opiate medication that each have different side effects, and this has led to a lack of consensus on the most appropriate or dosage medication. In this study, sufentanil and fentanyl were compared with placebo.

In this clinical trial study, 120 pregnant women who were candidates for elective cesarean section and the ages between 18 and 30 years were selected. After obtaining informed consent, they were randomly divided into three groups of 40 each. The groups included bupivacaine plus 20 μg fentanyl, or 2.5 μg sufentanil, or 0.5 cc normal saline. The duration and quality of analgesia, heart rate, blood pressure, and side effects including vomiting, itching, and chills were recorded.

The mean age of patients was 29.1 ± 5.1 (P = 0.75). The mean duration of analgesia in the fentanyl and sufentanil groups was more than the placebo group (P = 0.008). There was no significant difference in analgesic quality between the three groups (P = 0.68). Postoperative nausea was significantly higher in the fentanyl group than in the other groups (P = 0.021). The itching rate in the bupivacaine group was also significantly lower than the other two groups (P = 0.018).

According to the results of this study, the use of sufentanil increases the duration of analgesia and its side effects are less than fentanyl, so in cases such as elective cesarean section it can be used to increase the duration of nerve block.

Spinal anesthesia is commonly used in transurethral resection of the prostate (TURP). To reduce the complications of spinal anesthesia, opioids could be helpful in decreasing the amount of anesthetic drug. The aim of this study was to evaluate the effect of low doses of bupivacaine and fentanyl on the levels of sensory block and motor block.

A clinical trial was conducted in 80 TURP candidates in Babol Rouhani Hospital, 2016-2017. They were randomly divided into two groups (n= 40 per group) to receive either 7.5 mg bupivacaine 0.5% and 25 mcg of fentanyl (BF group) or 10mg bupivacaine 0.5% (B group). Duration of anesthesia, motor block (using Bromage score), pain intensity during the operation, and mean arterial pressure were recorded. Data were analyzed in SPSS V20.

There were no significant differences between the two groups in duration of anesthesia and mean arterial pressure (P<0.05). The mean score for pain was significantly lower in BF group than the B group (P=0.007). The levels of sensory block in group B were significantly higher than the BF group (P<0.001). Also, motor block return time and recovery time were significantly shorter in BF group than those in B group (P<0.001).

According to the current study, administration of bupivacaine and fentanyl can cause appropriate level of sensory block and could relief pain during TURP. Also, some complications such as long-term motor block and long-term staying in recovery would reduce.