Anesthesia & Clinical Research
Open Access

Abstract

Effect of Low Dose Bupivacaine and Fentanyl during Elective Cesarean Section under Spinal Anesthesia

Binita Acharya, Krishna Prasad Acharya, Shailendra Sigdel and Moda Nath Marhatta

Background: Intrathecal opioids have gained popularity in recent years as they augment the analgesia produced by local anesthetic agents. The purpose of this research is to study the effect of adding Fentanyl to low dose hyperbaric Bupivacaine for spinal anesthesia during cesarean delivery in terms of sensory blockade, hemodynamics and side effect profile.

Study design: Prospective randomized double blind study.

Method: Sixty, American Society of Anesthesiologist Physical Status (ASA PS) I and II parturients undergoing cesarean section under subarachnoid block were randomly divided into two groups; Group B received 2 ml (10 mg) hyperbaric 0.5% bupivacaine and 0.25 ml inj Normal Saline intrathecally and BF group received 2 ml (10 mg) 0.5% hyperbaric bupivacaine and 0.25 ml (12.5 μg) injection fentanyl intrathecally. Onset and extent of sensory and motor block, maternal hemodynamics, neonatal APGAR score and occurrence of maternal side effects were compared.

Results: The patients’ demographic data were comparable. The mean time to peak sensory level in B and BF groups were 7.92 minutes and 9 minutes (p=0.354) respectively. The mean duration of effective analgesia was 49.17 minutes and 64.73 minutes respectively in-group B and group BF (p=0.002). The mean time duration to twosegment regression was 76.30 minutes in-group Bupivacaine and 95.17 minutes in-group BF (p=0.001). Eleven patients in-group B (36%) required intraoperative rescue analgesia whereas only six patients (20%) in-group BF required intraoperative rescue analgesia (p=0.15). The incidence of hypotension in group B was 50% and in group BF was 23.33% (p=0.032). Thirteen patients in group B required inj Phenylephrine and only 4 patients required inj phenylephrine in group BF (p value 0.01). Neonatal APGAR score at 1 minute and 5 minutes of birth was similar in two groups.

Conclusion: From this double blind, randomized, prospective study, it was concluded that low dose Bupivacaine with Fentanyl provides prolonged period of sensory blockade with stable maternal hemodynamics and without maternal and neonatal side effects in elective cesarean section.