Editing Fentanyl (section)

=== Obstetrics ===
Fentanyl is sometimes given intrathecally as part of [[spinal anaesthesia|spinal anesthesia]] or epidurally for [[epidural anaesthesia]] and [[epidural analgesia|analgesia]]. Because of fentanyl's high lipid solubility, its effects are more localized than morphine, and some clinicians prefer to use morphine to get a wider spread of analgesia.<ref>{{cite journal | vauthors = Bujedo BM | title = Current evidence for spinal opioid selection in postoperative pain | journal = The Korean Journal of Pain | volume = 27 | issue = 3 | pages = 200–209 | date = July 2014 | pmid = 25031805 | pmc = 4099232 | doi = 10.3344/kjp.2014.27.3.200 }}</ref> It is widely used in [[Obstetrics|obstetrical]] anesthesia because of its short time to action peak (about 5 minutes), the rapid termination of its effect after a single dose, and the occurrence of relative cardiovascular stability.<ref name="Moisés_2005">{{cite journal | vauthors = Moisés EC, de Barros Duarte L, de Carvalho Cavalli R, Lanchote VL, Duarte G, da Cunha SP | title = Pharmacokinetics and transplacental distribution of fentanyl in epidural anesthesia for normal pregnant women | journal = European Journal of Clinical Pharmacology | volume = 61 | issue = 7 | pages = 517–522 | date = August 2005 | pmid = 16021436 | doi = 10.1007/s00228-005-0967-9 | s2cid = 26065578 }}</ref> In obstetrics, the dose must be closely regulated to prevent large amounts of transfer from mother to fetus. At high doses, the drug may act on the fetus to cause [[neonatal withdrawal]].<ref name="Moisés_2005" /> For this reason, shorter-acting agents such as [[alfentanyl]] or [[remifentanil]] may be more suitable in the context of inducing general anaesthesia.<ref>{{cite journal | vauthors = White LD, Hodsdon A, An GH, Thang C, Melhuish TM, Vlok R | title = Induction opioids for caesarean section under general anaesthesia: a systematic review and meta-analysis of randomised controlled trials | journal = International Journal of Obstetric Anesthesia | volume = 40 | pages = 4–13 | date = November 2019 | pmid = 31230994 | doi = 10.1016/j.ijoa.2019.04.007 | hdl = 10072/416502 | s2cid = 181816438 | url = https://researchonline.nd.edu.au/cgi/viewcontent.cgi?article=2384&context=med_article | hdl-access = free | access-date = 23 May 2022 | archive-date = 22 May 2022 | archive-url = https://web.archive.org/web/20220522185407/https://researchonline.nd.edu.au/cgi/viewcontent.cgi?article=2384&context=med_article | url-status = live }}</ref>