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Volume 5 Issue 8 (August, 2017)

Original Articles

To compare the effect of intrathecal Fentanyl with hyperbaric Bupivacaine on the quality of subarachnoid blockade in cesarean section
Manisha Pradhan, Shirish Prasad Amatya, Anil Shrestha, Roshan Piya, Niroj Hirachan

Background: In cesarean section (CS), subarachnoid blockade (SAB) is mostly preferred than general anesthesia. SAB is a simple technique, has rapid onset, dense neural blockade and also associated with negligible maternal and fetal risk. This study was conducted to compare the effect of intrathecal Fentanyl with hyperbaric Bupivacaine on the quality of SAB in CS. Materials & Methods:  This was conducted in the department of Anaesthesia, Patan hospital. The patients were randomly divided into two study groups by lottery method. Group 1 (n= 80): was given 2ml (10 mg) of 0.5% hyperbaric Bupivacaine plus 0.5 ml (25 µg) of fentanyl intrathecally, total volume=2.5 ml. Group 2 (n=80): was given 2ml (10mg) of 0.5% hyperbaric Bupivacaine plus 0.5ml NS intrathecally, total volume =2.5ml. Results: The mean age in group I was 38.54 ± 3.22 years and in group II was 36.14 ± 3.22 years. Mean height in group I was 162. 4± 6.00 m and in group II was 160.1± 3.22 m. Duration of surgery in group I was 122.2± 24 minutes and in group II was 120.2± 22 minutes. The difference was non- significant (P- 1). The onset of sensory analgesia was 2.26 ± 0.312 minutes in group I and 2.2 ± 0.30 minutes in group II. Time for maximum cephalic spread was 12.48 ± 3.25 minutes in group I and 11.40 ± 3.45 minutes in group II. Maximum analgesic block was T5-7 in group I and group II. Onset of motor block was 3.48 ± 0.99 minutes in group I and 3.51 ± 0.84 minutes in group II. Time for complete motor block was 6 ± 2.39 minutes in group I and 7.27 ± 2.30 minutes in group II. The difference was non- significant (P> 0.05). Time for two segment regression was 86.82 ± 10.80 minutes in group I and 128.11 ± 10.81 minutes in group II. Mean duration of analgesia was 198.12 ± 23.54 minutes in group I and 206 ± 18.23 minutes in group II. The difference was significant (P< 0.05). Conclusion: We found that addition of fentanyl to 0.5% hyperbaric bupivacaine for sub arachnoid blockage markedly improves the quality of intraoperative analgesia with minimal side effects. It also improved the quality of SAB in Cesarean section
Key words: Bupivacaine, Cesarean, fentanyl.

 
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