Effect of bupivacaine combined with fentanyl for simultaneous spinal-epidural anesthesia on hemodynamics, and maternal and infant outcomes in patients undergoing cesarean section

Purpose: To compare the effects of bupivacaine combined with fentanyl vs. bupivacaine alone in cesarean patients undergoing combined spinal-epidural anesthesia (CSE). Methods: This was a randomized controlled study that included 84 healthy women with singleton foetuses who were scheduled for cesarean delivery at Xuzhou Central hospital. They were divided into fentanyl combined with bupivacaine group (group A, n = 42) and bupivacaine alone group (Group B, n = 42). The primary outcome was hemodynamic changes in patients undergoing cesarean section while the secondary outcomes were neonatal Apgar score, incidence of intraoperative and postoperative adverse reactions and time to onset, and duration of anesthesia. Results: One hour after the surgery started, blood pressure was significantly lower in group A than in group B. Upon skin incision and one hour after commencement, the group A showed decreased heart rate compared with group B. Intraoperative pain level was significantly lower in group B than in group A. Compared with group A, group B has shorter motor block time, and duration of motor block was significantly longer in group B than in group A. Conclusion: Bupivacaine combined with fentanyl improves maternal hemodynamic stability during cesarean section, resulting in faster onset of anesthesia and prolonged motor block, but with no difference from bupivacaine alone in terms of intraoperative and intraoperative adverse reactions, neonatal cardiopulmonary and circulatory function.