Trial reportJournal of pain research2025
Low-Dose Ropivacaine-Fentanyl Spinal Anesthesia Combined with Carbetocin for Cesarean Section: A Randomized Double-Blind Non-Inferiority Trial.
Trial report in Journal of pain research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Purpose: Intrathecal fentanyl improves intraoperative analgesia and reduces hypotension by enhancing subtherapeutic local anesthetic doses during cesarean sections. This study explores whether these advantages are affected by the negative circulatory effects of carbetocin after delivery. Patients and Methods: This randomized double-blind, non-inferiority trial was conducted at a tertiary hospital in China. Sixty patients who underwent cesarean section, with singletons, were randomly assigned to receive either spinal anesthetic 15 mg ropivacaine combined with 10 µg fentanyl (Group F) or 16.5 mg ropivacaine (Group R). Slow intravenous carbetocin was routinely administered after delivery. Primary outcomes included hypotension incidence and anesthesia success rate (non-inferiority margin of 0.20). Secondary outcomes included analgesic supplementation time after anesthesia, vasopressor use, neonatal outcomes, patient satisfaction with anesthesia and postoperative analgesia, and adverse event incidence. Results: The incidence of hypotension in Groups F and R was 73.3% and 96.7%, and the success rate of anesthesia was 93.3% and 66.7%, respectively. Compared with Group R, Group F showed superior results in terms of the incidence of hypotension (difference: -23.3%; 95% confidence interval [CI], -40.4 to -6.2; Conclusion: Low-dose ropivacaine combined with fentanyl remains a recommended choice for spinal anesthesia in cesarean sections, alongside carbetocin administration.
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