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A Comparative Evaluation of Bupivacaine and Bupivacaine with Fentanyl in Lumbar Epidural Anaesthesia

Shweta Mahajan, Associate Professor, Deptt. of Anaesthesia and Critical Care, Indira Gandhi Medical College, Shimla, Himachal Pradesh 171001, India. , Shweta Mahajan1 , B.K Mohindra2 , Gurdeep Singh Sodhi3

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Journal of Pharmaceutical and Medicinal Chemistry 4(2):p 41-46, Jul-Dec 2018. | DOI: DOI: http://dx.doi.org/10.21088/jpmc.2395.6615.4218.1

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Abstract

Background: This study was carried out to assess the efficacy of epidural Fentanyl as intraoperative and postoperative analgesia when used along with bupivacaine epidurally. Materials and Methods: After taking the informed consent, 100 patients of ASA Grade 1 and 2 scheduled for elective lower abdominal or lower limb surgeries were randomly allocated into one of these two groups of 50 each. Group 1 patients received 15 ml of 0.5% bupivacaine by epidural route followed by 3 ml of boluses of bupivacaine after every 5 minutes if required till T10 level was achieved before start of surgery. Group 2 received 15 ml of bupivacaine with 1-2 µgm/kg of body weight fentanyl by epidural route followed by 3 ml of boluses of bupivacaine after every 5 minutes if required till T10 level was achieved before start of surgery. Both the groups were demographically similar and did not differ in term of pre-operative hemodynamics and mean duration of surgery. Patients were monitored for pain relief by VAS score and also hemodynamic and respiratory parameters were monitored both intraoperatively and for 3 hours in post-operative period. Results: The onset and maximum upper level of analgesia in Group 2 was statistically significant. The duration of analgesia in group 1 was less than group 2 and was found to be statistically significant. The mean of VAS in group 1 was 49.20±18.61 and in group 2 was 27.40±23.80 and this was found to be statistically significant. The sedation score was found to be statistically significant in group 2. Conclusion: Epidural fentanyl when added with epidural bupivacaine improves the quality, onset and duration of analgesia without causing any increase in intraoperative and post-operative complications.

Keywords: Epidural; Post-operative analgesia; Fentanyl; Bupivacaine.

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DOI: DOI: http://dx.doi.org/10.21088/jpmc.2395.6615.4218.1

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