Alfentanil in Elective Caesarean Sections under General Anaesthesia: Maternal Haemodynamic Changes Due to Intubation
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 2
Abstract
Background: Opioids administered before caesarean section under general anaesthesia reduce maternal stress response related to intubation and surgery but may decrease the Apgar score after delivery and when opioids are used. Aim: effect of low dose of shortacting opioid alfentanil on haemodynamic changes due to tracheal intubation during general anaesthesia for caesarean sections. Materials and Methods: Patients were taken for a period of 2 years in 60 pregnant patients between the ages of 18 and 40 years, scheduled for elective caesarean section, were assigned to two equal groups. GroupA:(N=30) Received alfentanil 10 mg/kg, diluted in normal saline (total volume of 10 ml), GroupP:(N=30) Received 10 ml normal saline as placebo for premedication. Results: There were no significant statistical differences among the two groups regarding age, weight, BIS and maternal preoperative haemodynamic parameters. Following alfentanil administration, systolic blood pressure decreased at 1, 5 and 10 min after endotracheal intubation. Diastolic blood pressure decreased only 1 min after intubation and heart rate decreased 1 and 5 min after intubation. There were significant statistical differences between the two groups in regard to mean heart rate 1 min after induction of anaesthesia (P = 0.01), 1 min after endotracheal intubation (P = 0.000) and 5 min after endotracheal intubation (P = 0.04). Mean BIS values were not significantly different between the two groups (P = 0.3). Mean of neonatal Apgar scores at 1 and 5 min and neonatal SpO2 were not significantly differerent between the two groups . Conclusion: Alfentanil as premedication decreased maternal systolic, diastolic blood pressure and heart rate in the 1st min of general anaesthesia for caesarean sections.
Authors and Affiliations
Srinivas Rapolu
A Comparative Study on Safety of Combined Spinal and Epidural Anesthesia verses Epidural Anesthesia for Orthopedic and Gynecological Surgery
Background: In major surgeries, anesthesia plan requires modification as per patient’s need for safe outcome. Orthopedic and gynecological surgeries require excellent surgical conditions and prolonged and effective posto...
Effect of Epidural Labour Analgesia on Maternal Body Temperature
Epidural analgesia is an effective mode of labour analgesia. Few studies have shown that epidural analgesia is associated with an increase in maternal body temperature. The greatest impact of this increase in maternal bo...
Intrathecal Bupivacaine with Neostigmine versus Clonidine as an Adjuvants in Lower Abdominal Surgeries
Background: A number of adjuvants to local anesthetics have been used intrathecally to prolong analgesia. So, the present study was planned to study the effect of intrathecal bupivacaine with neostigmine versus clonidine...
A Prospective Randomised Double-Blind Comparative Study of Bolus versus Fractionated Dose Injection in Spinal Anaesthesia for Pregnant Women undergoing elective Caesarean Section
Background: Elective or emergency caesarean sections are routinely done under spinal anaesthesia (SA) with bolus dose of local anaesthetic drugs. SA with bolus dose injection provides rapid onset of action but with profo...
Comparative Study between Modified Mallampathi and Extended Mallampathi and Thytomental Distance in Predicting Difficult Intubation in Obese Individuals
The modified Mallampati (MMP) classification is a standard method of oropharyngeal evaluation for predicting difficult laryngoscopy. Previous studies have demonstrated that the predictive value of the MMP is improved whe...