Effectiveness of Consecutive Versus Premixed Administration of Fentanyl and Bupivacaine in Subarachnoid Block for Total Abdominal Hysterectomy

Abstract

Background: Subarachnoid block (SAB) was a common regional anaesthetic technique, with opioids as adjuvants to enhance effectiveness and reduce hypotension. Objective: Comparison of the effectiveness of consecutive versus premixed administration of fentanyl and hyperbaric bupivacaine in subarachnoid block for TAH. Methods: This Quasi experimental study was carried out in 70 patients divided into two groups of 35 each: Group A received 0.5% hyperbaric bupivacaine 15mg (3ml) premixed with fentanyl 25µg (0.5ml) in a same syringe and Group Breceived fentanyl 25µg (0.5ml) in one syringe followed by 0.5% hyperbaric bupivacaine 15mg (3ml) in a separate syringe. The study compared the onset of sensory and motor block, reaching maximum sensory level, and complete motor block, as well as the time required for analgesia and ephedrine. Statistical significance was determined at a P-value < 0.05. Results: The study found that group B had significantly less time for onset of sensory block(3.45±0.41 vs 2.65±0.32min), motor block (4.51±0.53 vs 3.31±0.46min), and total ephedrine consumption (15.29±6.52 vs 11.86±5.95mg)compared to group A. Additionally, the time of sensory (236.8±21.7 vs 269.6±24.3 min) and motor block regression (203.8±18.6 vs 237.5±20.8min), and first required analgesia (248.2±23.3 vs 283.8±23.4 min)was longer in group B. Conclusion: Consecutive administration of fentanyl and hyperbaric bupivacaine is more effective than premixed administration in subarachnoid block for total abdominal hysterectomy.