A Comparison of the Effects of Fentanyl andRemifentanil on Nausea, Vomiting, and Painafter Cesarean Section

Background: the effects of different opioids on postoperativenausea and vomiting (ponv) and pain have not beenconclusively determined. the aim of this study was to comparethe effects of fentanyl, remifentanil or fentanyl plus morphineon the incidence of ponv and pain in women subjectedto cesarean section under general anesthesia.methods: the study was a randomized clinical trial recruiting96 parturients with american society of anesthesiologists(asa) physical status i and ii. they scheduled for cesareansection under general anesthesia using sodium thiopental,succynylcholine, and isoflurane o2/n2o 50/50 mixture.after clamping the umbilical cord, the patients weregiven fentanyl (2 ìg/kg/h), remifentanil (0.05 ìg/kg/h), orfentanyl (2 ìg/kg) pulse morphine (0.1 mg/kg) intravenously.visual analog scale for pain and nausea, frequency ofponv, meperidine and metoclopramide consumption wereevaluated at recovery, and 4, 8, 12 and 24 hours after thesurgery.results: there was no significant difference between the threegroups in terms of frequency of nausea, vomiting, and meannausea and pain scores at any time points. none of the patientsrequired the administration of metoclopramide. however, themean vas for pain in remifentanil-treated group was insignificantlymore than that in fentanyl- or fentanyl plus morphine-treated group at recovery or 4 hours after the surgery.the mean mepridine consumption in remifentanil-treatedgroup was significantly (p=0.001) more than that in fentanylorfentanyl plus morphine-treated group in 24 hours after thesurgery respectively. there was no significant difference inhemodynamic parameters of the three groups in all measurementsafter the surgery.conclusion: the findings of this study showed that early postoperativeanalgesia was better with fentanyl, and postoperativemeperidine consumption was significantly less with fentanylthan with remifentanil or combined fentayl and morphine.trial registration number: irct201010232405n5