Effects of epidural fentanyl and intravenous flurbiprofen for visceral pain during cesarean section under spinal anesthesia.

Purpose: Despite adequate levels of sensory blockade, patients sometimes complain of abdominal pain during cesarean section performed under spinal anesthesia. The aim of this study was to evaluate the effects of epidural fentanyl and intravenous flurbiprofen on visceral pain during cesarean section in patients having spinal anesthesia.

Methods: Thirty ASA physical status I and II patients undergoing elective cesarean section were studied. Spinal-epidural anesthesia was performed in all groups. Group A received no additional analgesics, group B received epidural fentanyl 100 mug, and group C received flurbiprofen 50 mg i.v. immediately after the delivery. Postdelivery, intraoperative visceral pain was evaluated by using the visual analog scale. Incidence and visual analog scale scores of visceral pain and incidence of intraoperative nausea and vomiting were obtained from each patient.

Results: Visual analog scale scores of pain were significantly lower in group B than in the other groups (P < 0.05). The incidence of nausea was comparable in all groups. The incidence of intraoperative vomiting was lower in group C than in the other groups (P < 0.05).

Conclusion: Epidural fentanyl, but not intravenous flurbiprofen, decreases the incidence and severity of visceral pain during cesarean section.