International Journal of Medical and Health Research

International Journal of Medical and Health Research


(MCI Approved Journal)

ISSN: 2454-9142

Vol. 4, Issue 3 (2018)

A randomized double blind clinical study comparing low dose hyperbaric bupivacaine and fentanyl mixture to a conventional dose of hyperbaric bupivacaine for caesarean section

Author(s): Dr. Rohan Deshmukh, Dr. Naseema Kanase, Dr. Vithal Dhulkhed, Dr. Soudamini Gandhi, Dr. Kunda Dimble
Abstract:
Introduction: Obstetric patients need strict dose calculations of local anesthetics, any greater dose can cause hemodynamic instability and lesser dose can produce inadequate block. Hence, we hypothesized in our study that by using low dose of bupivacaine with fentanyl can maintain stable hemodynamics and provide better analgesia.
Aim: To compare the hemodynamics and duration of analgesia using a low dose (7.5 mg) bupivacaine fentanyl mixture to a conventional dose (10 mg) of hyperbaric bupivacaine for cesarean section.
Design: Double-blinded, randomized, controlled prospective study conducted at a tertiary care hospital.
Materials and Methods: Sixty singleton parturient, scheduled for elective caesarean section were randomly allocated into two groups. Study group (group-BF) received a combination of 25 μg fentanyl and 7.5 mg of hyperbaric bupivacaine, whereas the control group (group-B) received 10 mg of hyperbaric bupivacaine. Maternal hemodynamics, sensory and motor block, duration of analgesia and Apgar score of newborn were compared between the groups.
Results: The time of onset of sensory analgesia and the time taken to achieve the highest sensory level was more in Group B than in Group BF which was statistically significant. The mean height of sensory analgesia was T4 (T3-T6) in both the groups. The mean time taken for two segment sensory regression and the mean time for sensory regression to L1 was prolonged in Group BF than in Group B which was statistically significant. The mean time of onset of Grade III motor block and the mean duration of motor block was more in Group B than in Group BF which was not statistically significant. Hemodynamic parameter HR, SBP, DBP changes per minute recorded in Group B and BF were almost similar & statistically not significant
Conclusion: The combination of low dose bupivacaine and fentanyl in comparison to bupivacaine alone has augmented the onset and prolonged the duration of sensory blockade. Onset and duration of motor block, intraoperative hemodynamic changes were comparable in both groups.
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