الفهرس 
Anatomy and Physiology of Spinal cord
Pharmacodynamic propertiesOnly 14 pages are availabe for public view
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Abstract
Cesarean Section is the most common obstetric surgery in the world. The rate of caesarean section increases dramatically in middle and high income countries. Spinal anesthesia is a preferred technique for cesarean delivery for its distinct advantages over general anesthesia as the simplicity of the technique, reliability, minimal fetal exposure to drugs, patients’ awareness and minimization of the hazards of aspiration.
Various adjuvants such as opioids have been added to the local anesthetic in an attempt to further minimize the side effects of the local anesthetics and prolong the duration of intraoperative and postoperative analgesia.
Fentanyl is a potent synthetic mu receptor–stimulating opioid, it was discovered to identify an improvement in human health analgesic over morphine beacuse it has a wide margin of safety, minimum effects on the cardiovascular and respiratory systems, and is readily reversible.
Pethidine it is a lipophilic opioid analgesic with local anesthetic effects when administered intrathecally, also it is the most commonly administered opioid in obstetrics.
The aim of our study is to evaluate the effect of fentanyl versus pethidine when added intrathecally to hyperbaric 0.5% bupivacaine in spinal anesthesia and their effect on pregnant women who undergo elective C.S as their sedative properties, ability to improve intra-operative and post-operative analgesia and neonatal outcome.
Fifty patients, ASA physical status II, aged between 18 to 45 years, scheduled for elective caesarean delivery under spinal anesthesia, randomly assigned to one of the study groups (n=25 each) using enveloped technique
group P: received Hyperbaric Bupivacaine 0.5%+25 mg of Pethidine (0.5 ml).
group F: received Hyperbaric Bupivacaine 0.5%+ 25μg Fentanyl (0.5ml).
Data regarding the onset of sensory blockade, time to S1 level sensory regression, time to reach Bromage 3 motor block and time of regression of motor block.
Hemodynamics data include MABP and changes in HR intraoperative was recorded.
Incidence of side effects like nausea, vomiting, shivering, purities, hypotension and bradycardia was assessed.
Our result showed short onset of sensory and motor blocks and prolongation of duration of duration of sensory and motor block by addition of Fentanyl as compared with Pethidine. Sensory level regression to S1 and motor block regression to Bromage 0 was significant prolonged in groupe (F) than groupe (P).
There is significant decrease in MABP in (P) group and increase in HR during intraoperative in comparison with (F) group.
First time require analgesia in 24 hours post-operative increases in (F) group than (P) group. There is no significant difference between two groups in side effects except shivering which was high in (F) group.