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Volume 6 Issue 2 (February, 2018)

Original Articles

Evaluation of Different Local Anesthetic Solutions for Extradural Anaesthesia in Elective Caesarean Section- A Comparative Study
Manjula Muchhal, Ramesh Chand Maheshwari

Introduction- The introduction of more concentrated solutions of bupivacaine and etidocaine has been reported to provide a more rapid onset of sensory and motor blockade with better analgesia during labour.The present study was conducted to compare the efficacy of bupivaciane, combination of bupivacaine with adrenaline and lignocaine and adrenaline in caesarean sections. Materials & Methods- The present study was conducted in the department of Gynaecology and Obstectrics on 60 women underwent elective caesarean section under extradural anaesthesia. Patients were divided into 3 groups of 20 each. Group I received 0.5% bupivacaine plain (B), group II received 0.5% bupivacaine with 1:200000 adrenaline (B + A) and group III received 2% lignocaine with 1:200 000 adrenaline (L + A).Parameters such as pain, need for extra solutions and quality of block were compared. Results- Group I had 20 patients (0.5% bupivacaine plain (B), group II had 20 patients (0.5% bupivacaine with 1:200000 adrenaline (B + A) and group III had 20 patients (2% lignocaine with 1:200 000 adrenaline (L + A). The difference was non- significant (P- 1).Pain was mild in group I (2), group II (1) and group III (8), moderate in group I (4), group II (1) and group III (6) and none in group I (14), group II (18) and group III (6). The difference was significant (P- 0.05).1 patient in group I and group II required IV fentanyl. 3 patients in group I and group II and 7 in group III required etradural diamorphine, 1 patient in group I required entonox and 1 in group received topical lignocaine. The difference was significant (P< 0.05).Quality of block was excellent in group I (13), group II (13) and group III (10), very good in group I (4), group II (7) and group III (6), good in group I (2), group II (0) and group III (2) and fair in group I (1), group II (0) and group III (2). The difference was significant (P< 0.05). Conclusion- Mixture of bupivacaine and lignocaine provided an excellent alternative to bupivacaine alone, and was superior to 2% lignocaine with adrenaline for elective Caesarean section. By reducing the dose of bupivacaine used, the combination may reduce the risk of cardiotoxicity. Key words-Bupivacaine, Caesarean, Lignocaine.

 
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