Comparison of 5 Mg (1 Ml) And 4 Mg (0.8 Ml) 0.5% Hyperbaric Bupivacaine with 25 Microgms Fentanyl in CSE Technique for Caesarean Section- A RCT
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 7
Abstract
Background and Objectives Patients undergoing caesarean section in spinal anaesthesia are at greater risk of hypotension than those not undergoing-caesarean section. In addition to aortocaval compression, the total dose of local anaesthetic drug used in subarachnoid block also plays an important role in determining the magnitude of arterial hypotension. The combination of reduced dose of local anaesthetics with intrathecal opioids makes it possible to achieve adequate spinal anaesthesia with minimum hypotension. The use of a lower dose aims to decrease maternal and foetal side-effects (hypotension, intraoperative nausea/vomiting). Intrathecal opioid improves the quality of analgesia and reduces local anaesthetic requirements with favourable effects on haemodynamic stability. In this study we have compared two low doses of bupivacaine with Fentanyl as additive for subarachnoid block in CSE for caesarean section. Methods: The study was carried out on 60 patients, 30 patients received subarachnoid 4mg(0.8 ml) of 0.5% hyperbaric bupvacaine with 25 microgms fentanyl (Group A) and 30 patients received Subarachnoid 5 mg(1 ml) of 0.5% hyperbaric bupvacaine with 25 microgms fentanyl (Group B) as a part of CSE technique for LSCS and hemodynamics and adequacy of anaethesia compared. Result: Spinal block provided excellent surgical anaesthesia in all patients. The mean time to reach T6 sensory level in both the groups was similar. Less patients in group A had hypotensive episodes as compared to group B (3 out of 30 versus 7 out of 30). Onset of sensory block till T6 as well as grade of motor block was comparable. Conclusions: We conclude that 4 mg of 0.5 % hyperbaric bupivacaine with 25 mcg fentanyl had better hemodynamic stability as compared to 5 mg of 0.5 % hyperbaric bupivacaine with 25 mcg fentanyl. It was also associated with good sensory and motor blockade.
Authors and Affiliations
Dr. Ankur Dixit
Keywords
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