Low dose hyperbaric bupivacaine and fentanyl for spinal anaesthesia in caesarean section
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 7, Issue 1
Abstract
Background and Aims: Neuraxial administration of opioids with local anaesthetics improves the quality of intraoperative analgesia and also provides postoperative pain relief for longer duration. The purpose of this study is to examine the effect of two different doses of inj Fentanyl with bupivacaine for caesarean section. Material and Methods A prospective randomized, double-blind study was performed in patients of ASA grade I and II undergoing elective caesarean section. Ninety female patients randomized into three groups. Group A received 0.5% hyperbaric bupivacaine 10 mg, Group B received 0.5% hyperbaric bupivacaine 7.5 mg + 12.5μg of Fentanyl + normal saline and Group C received 0.5% hyperbaric bupivacaine 7.5 mg + 25 μg of fentanyl (total volume 2ml) intrathecally. All the patients were assessed for onset and duration of sensory and motor block, maximum level of sensory block, haemodynamic stability, APGAR score and side effects like nausea, vomiting, respiratory depression, shivering and pruritus. Results The onset of sensory block was earlier and duration was longer in group C as compared to group A and B. (p <0.05). Onset of motor block was earlier and duration longer in group A than group B and group C, the difference being statistically significant (p<0.05). Haemodynamic parameters (PR and MAP) were stable and comparable intraoperatively in all the 3 groups (p>0.05). Quality of intraoperative analgesia was excellent in group B and C than group A. The difference in the three groups was statistically significant (p=0.0097). Pruritus was seen only in group C. The difference in the incidence of pruritus was statistically significant.(p=0.000) Conclusion Addition of 12.5 μg fentanyl to bupivacaine intrathecally causes less side effects as compared to 25 μg and results in early motor recovery hence it is recommended to use safely in caesarean section
Authors and Affiliations
S J Kulkarni, S O Ruhatiya, V P Kelkar, P P Nayak
Keywords
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