Original Research Article
Year: 2018 | Month: December | Volume: 5 | Issue: 12 | Pages: 148-155
A Comparative Study of Intrathecal Fentanyl Along with Bupivacaine and Bupivacaine Alone in Lower Segment Caesarean Section and Postoperative Analgesia
Dr. Ratnam Raoji
Associate Professor, Department of Anaesthesiology, Prathima Institute of Medical Sciences, Karimnagar, Telangana, India
ABSTRACT
Background: The addition of opioids like the lipophilic opioid fentanyl to local anaesthetics enhances surgical anaesthesia and prolongs the duration of anaesthesia in the postoperative period.
Aims and Objectives: To compare the efficacy of Intrathecal Fentanyl along with bupivacaine and bupivacaine alone and their effect on prolonging the duration of postoperative analgesia in lower segment caesarean section without any adverse effects on the foetus, determined clinically by the APGAR scoring.
Materials and Methods: The subjects included 50 patients belonging to ASA physical status I scheduled for lower segment caesarean section. Patients were randomly categorized in to two groups, group FB and group B consisting of 25 each. Patients in the group FB were given 8.5 mg of Bupivacaine plus 25 µg (0.5cc) fentanyl. Group B received 8.5 mg of Bupivacaine plus 0.5cc normal saline to adjust the final volume to 2.20 cc. Level of sensory block, duration of postoperative analgesia and any complications were noted.
Results: There was not much difference in the onset of analgesia in both the groups. Majority of the patients in both the groups had a higher level of sensory block at T4. The time to reach highest sensory level did not show any significant difference among the groups. Postoperative analgesia lasted for a longer time in Group FB than Group B, the difference being statistically significant. Among various complications observed, pruritus (20%) was the commonest followed by nausea, bradycardia and hypotension. In Group B, only 6 (24%) patients had adverse effects, out of which 3 had shivering, 2 had hypotension and one had bradycardia.
Conclusion: Fentanyl 25 µg does not enhance the onset and duration of sensory block produced by 8.5mg intrathecal hyperbaric bupivacaine. Fentanyl however prolongs postoperative analgesia and lowers the incidence of shivering.
Key words: Bupivacaine, Caesarian section, Fentanyl, Opioid, Spinal anaesthesia.
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