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Indian Journal of Anesthesia and Analgesia

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Ffficacy of Low Dose Intrathecal Fentanyl Added to Bupivacaine in Cesarean Section: An Observational Study

Aparna G. Chavan, Professor Department of ENT, Chirayu Medical College & Hospital, Bhopal, Madhya Pradesh 462030, India. , G.N. Chavan1 , Aparna G. Chavan2 , Vinod Narkhede3

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Indian Journal of Anesthesia and Analgesia 4(4):p 1051-1056, October-December 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.23

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Abstract

Context: Potentiating of the effects of intrathecal Local anesthetics by addition of Opioids for intraabdominal surgeries is a well established fact. Aims: To study effects of low dose fentanyl (12.5mcg) on the spinal block characteristics, quality of intraoperative surgical anesthesia and requirement of rescue analgesia in immediate post period. Settings and Design: A prospective,randomized,controlled study undertaken at Jawaharlal Nehru Medical College, Wardha during January 2014January 2015. Methods and Material: Ninety full term parturients posted for elective Cesarian Section were included after written informed consent. These 90 parturients were divided into two groups of 45 each, Group BF and Group BC. Group BF received intrathecal 2cc of 0.5% hyperbaric Bupivacaine + 0.25cc (12.5mcg) of preservative free Fentanyl (Total volume 2.25cc). Vital signs at every 2 minutes for first 10 minnutes, at 15 minutes for first 1hour and thereafter at 30 minutes interval until the patient complains of pain, sensory and motor block characteristics with side effects were observed throughout. Statistical Analysis Used: Means and SD, unpaired t test. Results: Time of onset of sensory analgesia was rapid in Fentanyl (BF) group than only Bupivacaine (BC) group [1.9±056 vs 2.46±079]. Two segment regression time group [129.11±31.26 vs 99.78±17.69], Complete sensory recovery [277.2±33.3 vs 185.0±29.8]and Total duration of effective analgesia [259.4±35.3 vs 165.0±29.8] were prolonged in BF and statistically significant as compared with BC group. Total duration of Grade III motor block was also significantly prolonged in BF group [137±33.4 vs 119±18.5]. However, incidence of side effects and APGAR scores were comparable in both the groups. Conclusions: Low dose intrathecal fentanyl markedly improves introperative analgesia, with insignificant hemodynamic effects significantly reduces the demand of analgesics in immediate postoperative period, therefore provides great maternal satisfaction and equal APGAR score in both groups compared.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4417.23

Keywords

Intrathecal; Fentanyl; Bupivacaine. 

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