English

Abstract

BACKGROUND: Puerperal Sterilization is one of the terminal contraceptive methods accounting for about 85% of all sterilizations in India. Various options are available to provide anaesthesia for puerperal sterilisation under laparoscopy. This study was aimed to evaluate the efficacy of fentanyl OxygenNitrous oxideHalothane sequence in providing adequate intraoperative anesthesia with less awareness, rapid recovery and extended postoperative analgesia. METHODS: Forty female patients of 20-40 years age group for puerperal sterilization were included in this study. With standard monitoring care, all patients were induced with fentanyl 2 mcg/kg, Oxygen-Nitrous oxide in the ratio of 50:50 with Halothane 0.5%. Halothane concentration was increased to 1% after 1 minute, 2% until the peritoneum was opened and maintained at 1% till the end of the surgery. RESULTS: Mean procedure duration was 20-30 minutes. Eye opening was observed within one minute in 3 patients, within 2 minutes in 29 patients and within 3 minutes in 8 patients. Verbal command response was in 2 minutes for 3 patients, 3 minutes in 29 patients and 8 patients in 4 minutes. Heart rate fluctuation was significant during the first 5 minutes (+/7.095) of surgical procedure. Fluctuation in systolic blood pressure was only 10-15% which lasted for few minutes in all these patients. There was no significant change in diastolic pressure and arterial oxygen saturation. Though two patients developed ventricular ectopics, it was subsided immediately after discontinuation of Halothane. CONCLUSION: Short acting fentanyl can be used safely with oxygen-nitrous oxide-halothane combination for short procedures like puerperal sterilization. This technique is safe as well as cost effective.