INTRATHECAL LOW DOSE BUPIVACAINE WITH FENTANYL VERSUS CONVENTIONAL DOSE OF BUPIVACAINE FOR CAESAREAN SECTION AND INFRAUMBILICAL SURGERIES: A RANDOMIZED CONTROLLED TRIAL
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Keywords
Intrathecal, low dose Bupivacaine with Fentanyl, conventional dose of Bupivacaine, caesarean section, infraumbilical surgeries
Abstract
Background: Spinal anaesthesia was described over 100 years ago. Since then neuroaxial administration has become advanced exponentially and now a days includes a huge variety of medication that provides not only anaesthesia including analgesia as well, spinal anaesthesia is most common method of regional blocked in caesarean section as well as in infraumbilical surgeries. Objective: To compare the hemodynamic stability and post-operative analgesia including sensory and motor-blockade of Intrathecal low dose of Bupivacaine along with Fentanyl with usual dose of intrathecal Bupivacaine in caesarean section and infraumbilical surgeries.
Methods: This is randomized controlled trial was conducted in patients posted for elective & emergency surgeries using low dose of bupivacaine with an adjuvant Fentanyl versus conventional dose of Bupivacaine in caesarean section and infraumbilical surgeries. Following approval by the Board of Thesis/Research committee, Department of Anesthesia & Ethical committee, Rohilkhand Medical College & Hospital Bareilly, 58 patients was randomly divided in two groups in 1:1 allocation ratio, each comprising 29 patients.
Result: the onset and duration of sensory and motor blocks, postoperative pain, and adverse effects like nausea, vomiting, and shivering. We found that there were no significant differences in age, gender, or weight found between the two groups. while comparing sensory and motor Blockade, Group 1 (low dose Bupivacaine + Fentanyl) exhibited earlier onset of both sensory and motor blockades. The mean onset time of sensory blockade in Group 1 was 4.13±1.15 minutes, significantly faster than Group 2 (7.25±0.81 minutes, p<0.001). Similarly, Group 1 experienced a quicker onset of motor blockade (5.58±0.86 minutes) compared to Group 2 (9.54±1.62 minutes, p<0.001). In our study when duration of sensory and motor blockade were assessed sensory blockade lasted longer in Group 1 (188.32±18.56 minutes) than in Group 2 (159.86±14.12 minutes, p<0.001), whereas motor blockade duration was longer in Group 2 (176.06±8.76 minutes) than in Group 1 (152.06±14.04 minutes, p<0.001).
Conclusion: The low-dose Bupivacaine with Fentanyl combination ensures better hemodynamic stability than the conventional Bupivacaine alone dose. Therefore, using this combination for spinal anesthesia is a more favorable option for cesarean sections and infraumbilical surgeries.
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Falak Deeba
Post Graduate, Department of Anaesthesiology, Rohilkhand Medical College & Hospital, Bareilly, UP India
Mohd Khalik
Professor, Department of Anaesthesiology, Rohilkhand Medical College & Hospital, Bareilly, UP India
Bhawna Singh
Associate Professor, Department of Anaesthesiology, Rohilkhand Medical College & Hospital, Bareilly, UP India