{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:16:20Z","timestamp":1792649780762,"version":"4.5.0"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background: Spinal anesthesia is considered the method of choice for elective cesarean sections; however, it is not without maternal\u2013fetal risks. Materials and Methods: This study compared the effects on maternal hemodynamics of intrathecal administration of fentanyl or morphine in parturients undergoing spinal anesthesia with 0.5% hyperbaric bupivacaine, with doses varied between 7.5 and 11 mg, depending on the patient\u2019s height. Data from a cohort of 170 parturients were analyzed. The administered doses were intrathecal morphine at 0.1 mL (100 \u00b5g, solution of 1 mg\/mL) or fentanyl at 0.25 mL (25 \u00b5g, solution of 50 \u00b5g\/mL). This study included 80 patients in the fentanyl (F) group and 90 in the morphine (M) group. Results: Group F showed significantly higher post-intervention systolic blood pressure values than group M (95.30 \u00b1 12.99 mmHg vs. 90.58 \u00b1 14.75 mmHg, p = 0.032). The incidence of vomiting was significantly less frequent in group F compared to group M (1, 1.3% vs. 10, 11.1%, p = 0.011). The total dose of ephedrine required for hypotension correction was significantly lower in the F group (12.75 \u00b1 13.26 mg vs. 17.72 \u00b1 16.73 mg, p = 0.035). Conclusions: The addition of fentanyl as an adjuvant alongside the local anesthetic in cesarean section is associated with enhanced hemodynamic stability compared to morphine, requiring lower doses of ephedrine and contributing to increased patient safety during elective cesarean surgery.<\/jats:p>","DOI":"10.3390\/ph18030392","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T08:59:52Z","timestamp":1741683592000},"page":"392","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Fentanyl and Morphine on Maternal Hemodynamics in Spinal Anesthesia for Cesarean Section"],"prefix":"10.3390","volume":"18","author":[{"given":"Ramona Celia","family":"Moisa","sequence":"first","affiliation":[{"name":"Clinic of Anaesthesia and Intensive Care, Pelican Clinic, Medicover Hospital, 4104869 Oradea, Romania"},{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0380-3381","authenticated-orcid":false,"given":"Nicoleta","family":"Negrut","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4196-0994","authenticated-orcid":false,"given":"Iulia Codruta","family":"Macovei","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cezar Cristian Mihai","family":"Moisa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1423-4681","authenticated-orcid":false,"given":"Harrie Toms","family":"John","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Epsom and St. Helier University Hospitals National Health Service Trust, Wrythe Lane, Carshalton, London SM5 1AA, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6831-0737","authenticated-orcid":false,"given":"Paula","family":"Marian","sequence":"additional","affiliation":[{"name":"Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"103175","DOI":"10.1016\/j.ijoa.2021.103175","article-title":"Prediction of spinal anesthesia-induced hypotension during elective cesarean section: A systematic review of prospective observational studies","volume":"47","author":"Yu","year":"2021","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Shahid, N., and Rashid, A.M. (2024). Knowledge, fear and acceptance rate of spinal anesthesia among pregnant women scheduled for cesarean section: A cross-sectional study from a tertiary care hospital in Karachi. BMC Anesthesiol., 24.","DOI":"10.1186\/s12871-024-02736-x"},{"key":"ref_3","first-page":"Cd002251","article-title":"Techniques for preventing hypotension during spinal anaesthesia for caesarean section","volume":"8","author":"Chooi","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1111\/j.1399-6576.2010.02239.x","article-title":"Definitions of hypotension after spinal anaesthesia for caesarean section: Literature search and application to parturients","volume":"54","author":"Roth","year":"2010","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1093\/bja\/aeu267","article-title":"Preventing spinal hypotension during caesarean delivery: What is the latest?","volume":"114","author":"Butwick","year":"2015","journal-title":"Br. J. Anaesth."},{"key":"ref_6","first-page":"778","article-title":"Frequency of post spinal hypotension in elective cesarean section after Spinal Anesthesia","volume":"6","author":"Khan","year":"2024","journal-title":"J. Popul. Ther. Clin. Pharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ebrie, A.M., Woldeyohanis, M., Abafita, B.J., Ali, S.A., Zemedkun, A., Yimer, Y., Ashebir, Z., and Mohammed, S. (2022). Hemodynamic and analgesic effect of intrathecal fentanyl with bupivacaine in patients undergoing elective cesarean section; a prospective Cohort Study. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0268318"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1097\/00115550-199924030-00015","article-title":"Intrathecal lipophilic opioids as adjuncts to surgical spinal anesthesia","volume":"24","author":"Hamber","year":"1999","journal-title":"Reg. Anesth. Pain Med."},{"key":"ref_9","unstructured":"Cummings, A., Orgill, B.D., and Fitzgerald, B.M. (2025, February 02). Intrathecal Morphine, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK499880\/."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.bpa.2023.02.002","article-title":"Management of adverse effects of intrathecal opioids in acute pain","volume":"37","author":"Grape","year":"2023","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"ref_11","first-page":"90","article-title":"Spinal anaesthesia-induced hypotension in obstetrics: Prevention and therapy","volume":"58","author":"Bujas","year":"2019","journal-title":"Acta Clin. Croat."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"13157","DOI":"10.53730\/ijhs.v6nS1.8430","article-title":"Effectiveness of intravenous lidocaine and fentanyl on attenuation of hemodynamic response to extubation for ear, nose and throat surgeries at JLNMCH, Bhagalpur, Bihar","volume":"6","author":"Ranjan","year":"2022","journal-title":"Int. J. Health Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1097\/00000542-198202000-00003","article-title":"Histamine release during morphine and fentanyl anesthesia","volume":"56","author":"Rosow","year":"1982","journal-title":"Anesthesiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1080\/03007995.2024.2373885","article-title":"Association between intraoperative hypotension and postoperative nausea and vomiting: A retrospective cohort study","volume":"40","author":"Goss","year":"2024","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"191","DOI":"10.5313\/wja.v3.i3.191","article-title":"Intrathecal morphine for postoperative analgesia: Current trends","volume":"3","author":"DeSousa","year":"2014","journal-title":"World J. Anesthesiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e8892","DOI":"10.1097\/MD.0000000000008892","article-title":"Perioperative analgesia after intrathecal fentanyl and morphine or morphine alone for cesarean section: A randomized controlled study","volume":"96","author":"Weigl","year":"2017","journal-title":"Medicine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S133","DOI":"10.36076\/ppj.2008\/11\/S133","article-title":"Opioid pharmacology","volume":"11","author":"Trescot","year":"2008","journal-title":"Pain Physician"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1053\/trap.2000.20600","article-title":"Hypotension and bradycardia during spinal anesthesia: Significance, prevention, and treatment","volume":"4","author":"Neal","year":"2000","journal-title":"Tech. Reg. Anesth. Pain Manag."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1186\/s13018-022-03215-0","article-title":"The use of intrathecal morphine for acute postoperative pain in lower limb arthroplasty surgery: A survey of practice at an academic hospital","volume":"17","author":"Sibanyoni","year":"2022","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1152\/physiol.00015.2020","article-title":"Multi-level regulation of opioid-induced respiratory depression","volume":"35","author":"Palkovic","year":"2020","journal-title":"Physiology"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Gallagher, A., Maria, S., Micalos, P., and Ahern, L. (2024). Effect of fentanyl compared to morphine on pain score and cardiorespiratory vital signs in out-of-hospital adult STEMI patients. Int. J. Paramed., 10\u201322.","DOI":"10.56068\/HJNX4647"}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/18\/3\/392\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:50:33Z","timestamp":1760028633000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/18\/3\/392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,11]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["ph18030392"],"URL":"https:\/\/doi.org\/10.3390\/ph18030392","relation":{},"ISSN":["1424-8247"],"issn-type":[{"value":"1424-8247","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,11]]}}}