Comparative Study of Low Doses of Intrathecal Bupivacaine Admixed With Fentanyl Citrate in Caesarean Section Deliveries
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 4
Abstract
Introduction: Spinal anaesthesia using hyperbaric bupivacaine is the technique of choice for caesarean section. Use of higher dose of local anaesthetics can cause haemodynamic instability, maternal and neonatal side effects. We hypothesized that use of lower dose of bupivacaine with fentanyl will improve the quality of analgesia and minimize the complications. Aim is to compare the haemodynamics and duration of analgesia using different lower doses of hyperbaric bupivacaine admixed with fentanyl citrate 12.5mcg. Methods: Seventy five parturients, scheduled for elective caesarean section were randomly allocated into three groups. Group B (n=25) received bupivacaine 10mg (2ml), group BF1 (n=25) received bupivacaine 7.5 mg and fentanyl 12.5 mcg plus NS (to make 2ml), group BF2 (n=25) received bupivacaine 5 mg and fentanyl 12.5 mcg plus NS (to make 2ml). Maternal haemodynamics, sensory and motor block, duration of analgesia and the apgar score of the newborn were compared between the groups. Results: The time required for sensory block was significantly fastest in group BF1(p<0.001). The haemodynamic trend was significantly different in 4th, 6th and 20th minute of intraoperative period and statistically significant but clinically not significant among the groups. Duration of analgesia was significantly longest (116.72±18.80) in group BF1 p<0.001. Analgesic supplement was maximum in group BF2 (10%) followed by group BF1 (4%), group B (0%) respectively. The analgesic quality was excellent in group BF1 (76%) followed by group B (64%), group BF2 (44%). Conclusion: Bupivacaine 7.5mg admixed with fentanyl 12.5 mcg is a better option to produce haemodynamically stable and prolonged duration of analgesia for caesarean section.
Authors and Affiliations
Dr. Khaidem Surjit Meetei, Dr. Ashem Jack Meitei, Dr. Tikendrajit Ningombam, Dr. Markitbok Ksanieng, Dr. Kh. Maniram Singh, Dr. N. Anita Devi
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