Epidural fentanyl and 0.5% bupivacaine for elective Caesarean section

Either 100 micrograms fentanyl or 2 ml saline was added to 0.5% bupivacaine administered epidurally for elective Caesarean section in 30 patients, in a double-blind randomised study. Bupivacaine 0.5% was administered until a complete sensory block was established extending to the 4th thoracic dermatome. One of the patients who received epidural fentanyl required intravenous alfentanil and Entonox and another, Entonox only briefly during surgery, compared with seven in the control group who required intravenous alfentanil and Entonox and one who required Entonox only. Postoperative analgesia was of longer duration in those who received epidural fentanyl (p less than 0.01). There were no deleterious effects on neonatal or maternal outcome.