EFFECT OF ADDITION OF FENTANYL TO LOW DOSE BUPIVACAINE IN CESAREAN SECTION UNDER SPINAL ANESTHESIA.

Dr. Mohammed Yahya*, Dr. Kaja Sriramamurthy, Dr. Seema Farhat and Dr. Sarita Kumari

ABSTRACT

Aims and objectives: The aim of this study was to know the reduction in spinal side effects by reducing the dose of bupivacaine with the addition of fentanyl to it, in caesarean section. We also compared duration of anesthesia and analgesia with standard dose of bupivavacaine for cesarean section under spinal anesthesia. Materials and methods: This is a prospective randomized controlled, double blinded study. Institutional ethical committee approval was obtained, sixty parturients with singleton pregnancy scheduled for cesarean section were randomly allocated into two groups of 30 each. Group C received 2.0ml(10mg) of 0.5% hyperbaric bupivacaine and Group F received 1.5ml(7.5mg) 0.5% hyperbaric bupivacaine plus fentanyl 0.5ml(25μg). Following parameters were recorded- blood pressur, heart rate, SPO2 along with sensory and motor blockade throughout the surgery. Complications like frequency of hypotension, bradycardia, nausea, vomiting were studied. Results: There was no significant difference in onset time of sensory and motor blockade between the two groups. Time to regression of sensory block to T10 in Group C was 153±19 min Vs Group F 178±11min and duration of analgesia in Group C was 133±19 min and Group F was 202±21min, which is clinically and statistically significant. There was no significant difference in duration of motor block between the two groups. The fall in blood pressure was significant in C group in comparison to F group (97.7±4.5 mmHg and 113.4±11.5 mm Hg) with a p value (<0.0001). The incidence of nausea and vomiting was also considerably low in F group. Conclusion: By reducing the dose of intrathecal bupivacaine with the addition of adjunctives like opioids, we can reduce common complications of spinal anesthesia. Addition of fentanyl to bupivacaine prolongs duration of analgesia in cesarean section, but it has no effect on onset time.

Keywords: Cesarean section, Bupivacaine, Fentanyl.