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Indian Journal of Clinical Anaesthesia


Comparative Study of Intrathecal Bupivacaine versus Bupivacaine with Fentanyl for Cesarean Section


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Author Details: Manoj Kumar N. Gajbhare, Neha P. Kamble

Volume : 3

Issue : 2

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 271

Article End Page : 277


Abstract

Background: Spinal anaesthesia for cesarean section has been the preferred technique for majority of anaesthesiologist. Maternal hypotension following spinal anaesthesia remains common place in cesarean delivery. The combination of reduced dose of local anaesthetics with intrathecal opioids makes it possible to achieve adequate spinal anaesthesia with minimum hypotension.
Objectives: The aim of our study was to compare the effectiveness of plain bupivacaine with low dose bupivacaine plus fentanyl with respect to sensory and motor blockade, hemodynamic changes, side effect profile and post-operative analgesia after spinal anaesthesia.
Material and methods: 60 patients undergoing elective cesarean section under spinal anaesthesia were randomly allocated to two equal groups; Group B patients received 10 mg (2 mL) of 0.5% hyperbaric bupivacaine and Group B + F received 8mg (1.6 mL) of 0.5% hyperbaric bupivacaine plus 20 ug (0.4 mL) preservative free fentanyl. The clinical profile of subarachnoid block in two groups and its effect on maternal and neonatal outcome was studied.
Results: The mean time required to reach peak sensory level was earlier in Group B + F. Mean time of two segment regression of sensory analgesia and complete sensory recovery was significantly earlier in Group B. Duration of motor recovery was earlier in Group B +F. Mean maximal heart rate was significantly more in Group B. Mean minimal systolic arterial pressure was significantly less in Group B compared to Group B + F. The duration of effective analgesia was significantly more in Group B + F (235.33+29.15) compared to Group B (120.33+10.98). The incidence of side effects was less in Group B + F than Group B.
Conclusion: We can conclude that the addition of low dose fentanyl to 0.5% hyperbaric bupivacaine for spinal anaesthesia in cesarean section provides satisfactory sensory and motor blockade, better hemodynamic stability, less side effects and effective post-operative analgesia.

Key words:
Bupivacaine, Fentanyl, Cesarean section, Spinal anaesthesia