Epidural fentanyl does not influence intravenous PCA requirements in the post-Caesarean patient

Forty ASA physical status I or II patients scheduled for elective Caesarean delivery were studied to determine the effect ofepidural fentanyl on post-Caesarean delivery analgesic requirements as administered by intravenous patient-controlled analgesia (PCA). Following delivery of the infant, under epidural anaesthesia with lidocaine 2% with 11200,000 epinephrine, patients were randomly assigned to receive either 10 ml of preservative-free normal saline via theepidural catheter or 100 μg of fentanyl with 8 ml preservative-free normal saline in a double-blinded fashion. On arrival in the post-anesthesia recovery room (PAR), patients were provided with intravenous PCA meperidine 12.5 mg every eight minutes as needed. Patients were visited at intervals over the next 24 hr to determine if any differences in narcotic requirements, demands for narcotics, or severity of pain were noted. No differences were observed in any values between the groups. It is concluded that a single bolus of épidural fentanyl does not provide an advantage for postoperative pain relief in this patient population.