Low Dose Bupivacaine plus Fentanyl in Subarachnoid Block for Caesarean Section

Authors

  • Nasir Uddin Ahmed Assistant Professor, Dept. of Anaesthesia and Intensive Care Unit, National Institute of Traumatology & Orthopedic Rehabilitation, Dhaka
  • Masuda Islam Khan Assistant Professor, Dept. of Obs & Gynae, BIRDEM Hospital, Dhaka
  • Aynul Islam Khan Child Specialist, National Institute of Kidney Diseases & Urology, Dhaka
  • AKM Akhtaruzzaman Professor, Dept. of Anaesthesia, Analgesia & Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka

DOI:

https://doi.org/10.3329/dmcj.v4i1.27628

Keywords:

Bupivacaine, caesarean delivery, fentanyl, spinal anaesthesia

Abstract

Background: Spinal anaesthesia induced hypotension, a common problem during caesarean section, is associated with maternal nausea and vomiting and the risk of neonatal acidosis. Low dose local anaesthetic combined with opioids spinal anaesthesia better preserves maternal haemodynamic stability, resulting in equally efficacious anaesthesia.

Objectives: To investigate whether this synergistic action could be used to provide effective anaesthesia while preventing hypotension during caesarean operation.

Materials and method: This prospective study included 60 pregnant mothers scheduled for caesarean operation who were then divided into two groups (thirty in each). Group-A received a spinal injection of 12.5 mg of standardized 0.5% hyperbaric bupivacaine and group-B received 8 mg of 0.5% hyperbaric bupivacaine with 20 ?gm fentanyl. Hypotension was defined as the systolic blood pressure drops below 90 mm of Hg or a decrease of systolic blood pressure 25% from pre anaesthesia level and hypotension was treated with a bolus of 5 to 10 mg of intravenous ephedrine. The quality of anaesthesia and postoperative analgesia were evaluated.

Results: The mean time required to reach peak sensory level was earlier in group-B than group-A and was statistically significant (p<0.05). The decrease in systolic blood pressure in group-A was significantly more than group-B (p<0.05) and vasopressor requirement was also significantly more in group-A compared to group-B (p<0.05). Mean time of two segment regression of sensory analgesia and complete sensory recovery was significantly early in group-B (p<0.05). Duration of motor recovery in group-B was significantly earlier (p<0.05). The duration of effective analgesia was significantly more in group-B (p<0.05).

Conclusion: Low dose Bupivacaine with fentanyl provided excellent intraoperative sensory and motor blockade, haemodynamic stability, and effective postoperative analgesia for caesarean delivery.

Delta Med Col J. Jan 2016 4(1): 24-30

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Author Biography

Nasir Uddin Ahmed, Assistant Professor, Dept. of Anaesthesia and Intensive Care Unit, National Institute of Traumatology & Orthopedic Rehabilitation, Dhaka



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Published

2016-05-07

How to Cite

Ahmed, N. U., Khan, M. I., Khan, A. I., & Akhtaruzzaman, A. (2016). Low Dose Bupivacaine plus Fentanyl in Subarachnoid Block for Caesarean Section. Delta Medical College Journal, 4(1), 24–30. https://doi.org/10.3329/dmcj.v4i1.27628

Issue

Vol. 4 No. 1 (2016)

Section

Original Articles

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