Introduction:

Fentanyl offers good anesthetic efficacy and fewer effects on the sympathetic nervous system with better hemodynamic status, but its effect in combination with other anesthetics in pregnant women has not been fully described.

Objective:

To evaluate the anesthetic efficacy and safety of multimodal anesthesia with fentanyl in pregnant women undergoing caesarean section.

Material and methods:

Controlled, randomized, double blinded clinical trial; in pregnant women scheduled for cesarean section distributed in 3 groups: FBMD group: fentanyl 70 μg + hyperbaric bupivacaine 0.1%, 2 mg, + morphine 100 μg + dexmedetomidine 5 μg; BFM group: hyperbaric bupivaine 0.25%, 5 mg, + fentanyl 25 μg + morphine 100 μg, and group BM: hyperbaric bupivacaine 0.375%, 7.5 mg, + morphine 100 μg. The anesthetic efficacy was evaluated: prior to the incision, during the dissection of the abdominal wall, upon entry to the abdominal cavity, in the revision of parietocolic slides and in the immediate postoperative period, as well as the vital signs.

Results:

180 women were analyzed. The FBMD group showed greater anesthetic efficacy in the revision of parietocolic slides (p = 0.01) and in the immediate postoperative period (p = 0.0001) and greater safety, showing better hemodynamic control at minutes 1 and 10 (p = 0.02 y p = 0.03 respectively).

Conclusions:

Multimodal anesthesia with FMBD shows better anesthetic efficacy and safety over hemodynamic control.