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 83
- Downloads 0
A Study to Compare Effects of Magnesium Sulphate and Fentanyl with Bupivacaine for Postoperative Analgesia in Perianal Surgeries
Context: Magnesium prolongs analgesia in humans when given intrathecally. Fentanyl being highly lipid soluble diffuses into spinal cord and binds to dorsal horn receptors rapidly when administered intrathecally.Aims: To...
Preventive Analgesic Efficacy of Intravenous Tramadol Versus Intravenous Nalbuphine for Elective Inguinal Hernia Repair Surgeries :Randomised Controlled Trial
Background Information: One of the challenges in postoperative care in a developing country is the non-availability of narcotics. Morphine and fentanyl have excellent analgesic action but they are difficult procure as th...
A Comparative Study: Ultrasound Guided Transverse Abdominis Plane Block versus Caudal Block in Paediatric Patients for Lower Abdominal Surgeries
Background: Paediatric patients undergoing lower abdominal surgeries require adequate pain relief peri operatively, which is often neglected. Various methods of pain relief in paediatric patients are systemic opioids, NS...
A Comparison of Injection of 0.375% Ropivacaine before and after the Bifurcation of Sciatic Nerve for Ultrasound Guided Popliteal Block
Introduction: Lower limb surgeries were performed under popliteal block. Over the years Sciatic nerve has been blocked pre bifurcation by using peripheral nerve stimulator and blind techniques. But thanks to the Ultrasou...
Tap the Potential of Tap Block: A Schematic Representation
ransversus abdominis plane (TAP) block is an abdominal or truncal field block. Its popularity has increased in the recent times, mainly because its widespread applicability in several abdominal surgeries and less inciden...