Abstract

Background: This randomised study was conducted to compare the synergistic effect of intrathecally administered Fentanyl & hyperbaric Bupivacaine on haemodynamic, sensory & motor block characteristics and side effects, on pregnant women undergoing caesarean section under spinal anaesthesia. Methods: One hundred twenty women were randomized into four groups of thirty each. Group-I (n=30) received 0.5% Bupivacaine 1.8ml (9mg) +25µg Fentanyl, Group-II (n=30) received 0.5% Bupivacaine 1.6ml (8mg) +25µg Fentanyl, Group-III (n=30) received 0.5% Bupivacaine 1.4ml (7mg)+ 25µg Fentanyl and GroupIV (n=30) received 0.5% Bupivacaine 1.2ml (6mg)+25µg Fentanyl. Results: Onset of sensory block to T6 dermatome occurred faster with increasing Bupivacaine doses from 6mg to 9mg. Onset of motor block was also earlier in Group I. Total duration of analgesia and motor block were longer in group I than in other groups. The addition of Fentanyl to Bupivacaine significantly delayed the postoperative pain and sensory recovery. Conclusion: Addition of Fentanyl 25µg to 0.5% hyperbaric Bupivacaine 6mg,& 7mg was effective for spinal anaesthesia in caesarean section surgeries, with minimal side effects. Combinations of 8mg & 9mg of 0.5% bupivacaine with fentanyl 25µg provide more duration of analgesia when compared to 6mg and 7mg, but with increased side effects and prolonged duration of motor block, which interferes with early ambulation.

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