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Indian Journal of Anesthesia and Analgesia

Volume  5, Issue 7, July 2018, Pages 1232-1238


Original Article

A Comparative Evaluation of Intrathecal Administration of Hyperbaric Bupivacaine alone and in Combination of Different Low Doses of Hyperbaric Bupivacaine with Fentanyl in Cesarean Section
Dogra Ravikant1, Kumar Ramesh2, Verma Anjana3
1,2Associate Professor, Department of Anaesthesia, Indira Gandhi Medical College, Shimla, Himachal Pradesh 171001, India. 3Senior Resident, Department of Anaesthesia, Dr. Yashwant Singh Parmar Government Medical College Nahan, Himachal Pradesh 173001, India.
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Background: This randomized study was conducted to compare the synergistic effect of intrathecally administered fentanyl and hyperbaric bupivacaine on hemodynamic, sensory and motor block characteristics alongwith their side effects.

Context: This randomized study was done on pregnant women undergoing caesarean section under spinal anaesthesia.

Aims: To compare and determine the efficacy of spinal anaesthesia with bupivacaine alone and in combination of different low doses of bupivacaine with additive fentanyl.

Settings and Design: This study included 75 pregnant women scheduled for caesarean section who were then randomized into three groups of twenty five each. Group 1 (B group) received 12.5 mg (2.5 ml) of 0.5% of hyperbaric bupivacaine intrathecally, Group 2 (BF1 group) received 10 mg (2 ml) of 0.5% of hyperbaric bupivacaine + 12.5µg (0.5ml) fentanyl intrathecally, Group 3 (BF2group) received 8 mg (1.6ml of 0.5%) of hyperbaric bupivacaine + 12.5µg (0.5ml) fentanyl + 0.4 ml normal saline intrathecally.

Statistical analysis used: The data of the study were recorded in the record chart and results were evaluated using statistical tests (ANOVA, student t-test, chi-square test and post hoc test, F-test whichever was applicable. 

Results: Onset of sensory block to T10 dermatome occurred faster with increasing bupivacaine doses. Onset of motor block and duration of motor block was also longer in group B as compared to BF1 and BF2. The addition of Fentanyl to Bupivacaine significantly delayed the postoperative pain and sensory recovery.

Conclusions: Spinal anaesthesia for cesarean delivery using low dose hyperbaric bupivacaine in combination with fentanyl is associated with significantly less hypotension, vasopressor requirement and nausea.

Keywords: Bupivacaine; Caesarean Section; Fentanyl; Spinal Anesthesia.

Corresponding Author : Ramesh Kumar, Associate Professor, Department of Anaesthesia, Indira Gandhi Medical College, Shimla, Himachal Pradesh 171001, India.