Comparison Between The Efficacy of Fentanyl Continuous Infusion and Intratechal Morphine for Pain After Cesarean Section

Prabowo Wicaksono Yuwono Putro


Background:. Intrathecal morphine proved to be effective caesarean section with possible side effect delayed respiratory depression, nausea vomiting and pruritus. Fentanyl continuous infusion fixed base infusion rate with disposable elastomeric pump is an alternative to intrathecal morphine. However,  the effectiveness has not been proven. Objective: to compare effectiveness between fentanyl continuous infusion fixed base infusion rate using disposable elastomeric pump and intrathecal morphine.

Methods: RCT with 56 patients who met the inclusion criteria, divided into two groups: group Morphine (n=28): spinal anesthesia 10 mg Bupivacaine Heavy 0.5% + 100 mcg morphine; group Fentanyl (n=28): spinal anesthesia  10 mg Bupivacaine Heavy 0.5% + fentanyl continuous infusion 0.5 mcg/kg BW/hour using disposable elastomeric pump after delivery of the fetus. Data analysis: Mann-Whitney test level of significance p < 0.05.

Results: Analgesic effect of Fentanyl group was as effective as Morphine group. NRS score difference significantly only in measurement taken 6 hours after surgery (p=0.034). Mean NRS score group Morphine (0.68±1.02) and mean NRS score group Fentanyl (1.11±0.832). Both group were effective in preventing increased cortisol level measured 6 hours after surgery, mean value group Morphine (15.053±8.664) and mean value group Fentanyl (12.162±8.623); no statistical significant difference between group (p=0.114). Side effects revealed no significant difference.

Conclusion: Fentanyl continuous infusion 0.5 mcg/kg BW/hour using disposable elastomeric pump is as effective as intrathecal morphine 100 mcg.


Pain; caesarean section; intrathecal morphine, fentanyl continuous infusion, disposable elastomeric pump; NRS; OOAPS; cortisol.

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