Low dose hyperbaric bupivacaine and fentanyl for spinal anaesthesia in caesarean section

2018 ◽  
Vol 7 (1) ◽  
pp. 06-12
Author(s):  
S J Kulkarni ◽  
◽  
S O Ruhatiya ◽  
V P Kelkar ◽  
P P Nayak ◽  
...  
2016 ◽  
Vol 4 (1) ◽  
pp. 24-30
Author(s):  
Nasir Uddin Ahmed ◽  
Masuda Islam Khan ◽  
Aynul Islam Khan ◽  
AKM Akhtaruzzaman

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


2006 ◽  
Vol 23 (4) ◽  
pp. 285-291 ◽  
Author(s):  
S. Karaman ◽  
S. Kocabas ◽  
M. Uyar ◽  
S. Hayzaran ◽  
V. Firat

2019 ◽  
pp. 1-3
Author(s):  
Dhananjay Yadav

[1] Kanazi GE, Aouad Mt, KJabbour-Khoury SI et al: Effect of low dose dexmedetomidine or clonidine on the characteristics of spinal bupivacaine block. Act a Anaesthesiol Scand 2006;50:222-7 [2] Hala EEA, Mohamed SA, Hend Y. Dose related prolongation of hyperbaric bupivacaine spinal anaesthesia by dexmedetomidine. Ain Shams J Anaesthesiology 2011;4:83-95 [3] Kim JE, Kim NY, Lee HS, Kil HK. Effects of intrathecal dexmedetomidine on low dose bupivacaine spinal anaesthesia in elderly patients undergoing transurethral prostectomy. Bio Pharm Bul 2013;36;959-965. [4] Mahendru V, Tewari A, Katyal S et al. A Comparison of intrathecal dexmedetomidine, clonidine, & fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery: A double blind controlled study. J Anaesthesiol Clin Phrmacol 2013;29:496-502 [5] Soumya samal et al: Intrathecal buterphenol or intrathecal dexmedetomidine for post operative analgesia a comparative study: healt agenda, vol 2. Issue 1. Jan 2014 [6] Dexmedetomidine in anaesthesia practice: a wonder drug? IJAaug 2014 by S K Harsoor [7] Sudheesh K, Raghvendra Rao R S, Kavya M, Aarthi J, Rani D D, Nethra S S. Comprative study of 2 doses of intrathecal dexmedetomidine as adjunct with low dose hyperbaric bupivacaine in ambulatory perianal surgeries. A prospective randomized controlled study. Indian J Anaesth 2015;59:648-52 [8] El-Attar A, Aleen MA, Beltagy R, Ahmed W. A comparative study of intrathecal dexmedetomidine and fentanyl as additives to bupivacaine. Res Opin Anesth Intensive care 2015;1:43-9 [9] Kurhekar P, Kumar SM, Sampath D. Comparative evaluation of intrathecal morphine and intrathecal dexmedetomidine in patients undergoing gynecological surgeries under spinal anaesthesia. A prospective randomized double blind study. Indian J anaestg 2016;60:382-7


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