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Opioid analgesic drugs are the main treatment of patients during anesthesia. Although highly effective, their use is not without problems. One is the increasing requirement of these address the same nociceptive stimulus.
Opioid induced hyperalgesia could be an explanation studies in animal models. Through mechanisms where N-methyl-D-aspartate receptors, glutamatergic system disturbances and changes in intracellular calcium regulation involved.
The hyperalgesia induced by intrathecal opioids is controversial. The investigators propose a model study in patients undergoing cesarean section to study the secondary hyperalgesia induced based on the study of nociceptive thresholds with two methods opioids: Von Frey filaments and digital algometer.
If intrathecal fentanyl is used in spinal anesthesia for elective cesarean section, then, an increase in sensitivity will occur. This increase can be measured by von Frey filaments, expressed in increased requirement clinically opioids.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| H-Bupivacaine 11.5 mg + fentanyl 25 mcg. | Experimental | Intrathecal administration of Hyperbaric Bupivacaine 1.5 ml 0.75% plus fentanyl 25 mcg. |
|
| H-Bupivacaine 11.5 mg. | Active Comparator | Intrathecal administration of Hyperbaric Bupivacaine 1.5 ml 0.75% |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| H-Bupivacaine | Drug | Intrathecal administration of hyperbaric bupivacaine 1.5 ml 0.75% |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Punctate - Von frey (grams) | Change from Baseline in punctate sensibility at 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Pressure pain - algometer (kg/cm/cm) | Change from Baseline in pressure pain at 48 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Juan Carlos De la Cuadra, MD | Contact | +56-2-23543270 | juancarl@med.puc.cl | |
| Hernan Auad, MD | Contact | +56-2-23543270 | hernan_auad@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Luis I Cortinez, MD | Ponticia Universidad Católica | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Clinico Pontificia Universidad Catolica | Recruiting | Santiago | Santiago Metropolitan | 8330024 | Chile |
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| ID | Term |
|---|---|
| D005283 | Fentanyl |
| ID | Term |
|---|---|
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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|
| Fentanyl | Drug | Intrathecal administration of fentanyl 25 mcg |
|