Intrathecal fentanyl and intraoperative pain during fetoscopic laser photocoagulation: a single-center retrospective cohort study (2020-2025).

BACKGROUND

Intrathecal fentanyl is used as an adjunct to spinal anesthesia for cesarean delivery; however, its role during fetoscopic laser photocoagulation has not been studied. We evaluated its association with intraoperative pain during fetoscopic laser photocoagulation.

METHODS

In this retrospective study, patients who underwent fetoscopic laser photocoagulation under spinal anesthesia were grouped according to intrathecal fentanyl use. The primary outcome was intraoperative pain, which was defined as patient-reported pain. Multivariable logistic regression was performed to adjust for potential confounders.

RESULTS

Among 172 patients, intraoperative pain occurred less frequently with intrathecal fentanyl (22.9% vs. 40.4%; P = 0.015). Multivariable analysis showed that intrathecal fentanyl was independently associated with a reduced risk of intraoperative pain (odds ratio, 0.33; 95% confidence interval, 0.15-0.71; P = 0.005). Maternal and fetal adverse events did not differ between the groups.

CONCLUSION

Intrathecal fentanyl was associated with reduced intraoperative pain during fetoscopic laser photocoagulation without an increase in adverse events.