A Comparative Study of Combined Spinal Epidural with Epidural for Labour Analgesia Using Lower Concentrations of Bupivacaine and Fentanyl
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 7
Abstract
Aim: 1. To compare the analgesic efficacy of combined spinal epidural with epidural for labour analgesia using lower concentrations of Bupivacaine and Fentanyl. 2. To asses the effects of these agents on the maternal physiology, progress and duration of labour, mode of delivery, foetal and neonatal outcome. Methods : A total of 40 labouring parturients of ASA 1 & 2 have been divided in to 2 groups (Epidural group & Combined Spinal Epidural group) with 20 in each group. Epidural group received 10 ml of 0.0625% Bupivacaine and 50 mcg of Fentanyl epiduraly as initial bolus, followed by intermittent epidural top ups of 7 ml of 0.0625% Bupivacaine and 2mcg/ml of Fentanyl every 1 hr. Combined Spinal Epidural group received 1.5 ml solution containing 0.625 mg of Bupivacaine and 25 mcg of Fentanyl intrathecally and followed 2 hrs later by intermittent top ups of 6 ml of 0.0625% Bupivacaine and 2mcg/ml of Fentanyl every 1 hr. Results : With respect to the onset and quality of analgesia in Epidural and CSE groups, there were statistically significant differences. Analgesic efficacy was compared in terms of Time of first painless contraction, Time of loss of sensation to pin prick, visual analogue pain scales during first and second stage, Episiotomy pain relief and global assessment of quality of analgesia. CSE group showed statistically significant differences in terms of onset and quality of analgesia. No significant variations in duration and mode of delivery, maternal side effects and neonatal outcome. Conclusion: CSE when compared to plain Epidural produced statistically significant pain relief and the side effects produced by combining Fentanyl and Bupivacaine on maternal power, passage and passenger were minimal, proving that the CSE is a safer and good alternative to epidural or labour analgesia.
Authors and Affiliations
M. R. Karthikeyan
Keywords
Related Articles
- EP ID EP533883
- DOI 10.21088/ijaa.2349.8471.5718.11
- Views 106
- Downloads 0
A Prospective Randomised Study of the Effects of Pregabalin Oral Versus Dexmedetomidine Infusion on Intra Operative Hemodynamic Stability in Patients Undergoing Laparoscopic Cholecystectomy
Context: Many agents are being tried to prevent acute changes in hemodynamics taking place during surgery as a result of intubation and other invasive procedures. Over the period of time dexmedetomidine has evolved as sa...
Study of Effect of Ramosetron and Granisetron in Prevention of Post Operative Nausea and Vomiting Following Laproscopic Cholecystectomy
ost operative nausea and vomiting following laparoscopic cholecystectomy is a common complication. This study was designed to analyze and compare efficacy and adverse effect of ramosetron and granisetron in prevention of...
Dexemedetomidine and Clonidine as Adjuvant to Local Anaesthetic Agent in Epidural Anaesthesia
Background: Many anesthetic drug combinations have been used in patients to improve regional anaesthesia. This study was planned to compare the analgesic and sedative effects of dexmedetomidine and clonidine as an adjuva...
Evaluation of Pre Incision Infiltration of A Local Anesthetics Regimen Prior to Modified Radical Mastectomy: A Randomized Single Blinded Study
Introduction: Breast surgery can be emotionally distressing and physically painful. Although regional anesthesia and nerve block techniques are widely used in many situations, many anesthetists are still minded by the si...
Comparision of the Postoperative Analgesic Efficacy of Bupivacaine 0.125% 1ml/kg versus Bupivacaine 0.125% 1ml/kg and Fentanyl 1 µg/kg for Caudal Analgesia in Paediatric Patients undergoing Short Surgical Procedures
Aims: To compare the postoperative analgesic efficacy of bupivacaine 0.125%1ml/kg versus bupivacaine 0.125% 1ml/kg and fentanyl 1 µg/kg for caudal anaesthesia in paediatric patients undergoing short surgical procedures....