Comparison among subarachnoid opioid mix for cesarean section – An observational study

OPEN How to cite this article Osorio-Gutiérrez CI, Ortiz-Gómez GA, Valencia-Ríos JF, Arango-Gómez F. Comparison among subarachnoid opioid mix for cesarean section – An observational study. Colombian Journal of Anesthesiology. 2021;49(1):e940. Introduction Classically, the local anesthetic (LA) has been combined with one lipophilic and another hydrophilic opioid for neuraxial anesthesia in cesarean section. In Colombia, the practice has been the use of morphine hydrochloride with fentanyl, but the occasional shortage of the former triggered an interest in new options. In response to the shortage of morphine in 2017-2018, a contingency plan was developed at the SES Hospital in Caldas, prefilling syringes at the hospital compounding central, with: bupivacaine, morphine and fentanyl (BMF); bupivacaine, fentanyl and hydromorphone (BFH); and bupivacaine and hydromorphone (BH). Hydromorphone has a rapid onset of action, long-lasting effect and is indicated for spinal administration in the safety data sheet; therefore, the advantages of adding fentanyl to this mix are questionable.