A Comparison of Intrathecal Fentanyl or Placebo Added To Bupivacaine in Prevention of Intra-Operative and Early PostOperative Emesis in Cesarean Section Performed Under Spinal Anaesthesia
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Background: The high incidence of intraoperative nausea and vomiting in cesarean section under spinal anaesthesia is distressing to the parturients and disturbing to the surgeons by causing protrusion of abdominal viscera rendering surgery more difficult and increasing the risk of visceral injuries, aspiration being an additional hazard.Many methods have been used to reduce the incidence of nausea and vomiting but they add to cost and side effects. Intrathecal lipophilic opioids added to bupivacaine as an adjuvant have been shown to reduce incidence of nausea and vomiting, it is inexpensive has few serious side effects and is established as adjuvant.Hence could be good alternative for prophylaxis of emetic episodes in cesarean section under spinal anaesthesia, thus basis of our study. Material methods: 100 parturients of ASA physical status I and II in the age group 25-40 years undergoing elective cesarean section under spinal anaesthesia were randomized into two groups of 50 each...Study Group recieved 0.5% hperbaric bupivacaine 2 ml + fentanyl 12.5 µg in 0.5 ml 0.9% saline.Control Group recieved 0.5% bupivacaine 2ml + 0.9% saline 0.5 ml intrathecally,and observations were made. The data was analyzed statistically. All the statistical results have been discussed at 5% level of significance. The p-value <0.05 was considered significant. Results The incidence of nausea in 24hr period was 18% vs 52% (p≤0.007).Retching was 6 % vs 38% (p ≤0.0002). Vomiting was 2 % vs. 26% (p≤0.008) in study and control group respectively rescue antiemetic used in study group (n=3) vs. control group (n=21) (P value≤0.0002). Duration of analgesic was 170min ±8.4 2vs 127min±7.46 (P–value <0.0001). VAS score was 0.52±0.027 vs. 0.86±0.22 (p -value=0.03). Mean Apgar score at 1 min was 7.4vs7.56 respectively and at 5 min interval was 9.3 vs. 9.04 respectively in two groups (p value= 0.317) Conclusion low dose intrathecal fentanyl 12.5µg, when used as adjuvant with 0.5% bupivacaine heavy for spinal anesthesia for parturients undergoing cesarean section, decreases incidence of emesis in perioperative operative period, apart from increasing quality of analgesia with no serious side effects in parturient and new born.
Authors and Affiliations
Asif Iqbal
Keywords
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- EP ID EP572292
- DOI 10.9790/0853-1804044046.
- Views 29
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