POST OPERATIVE ANALGESIC EFFECT OF INTRATHECAL FENTANYL AS AN ADJUVANT TO 0.5% HYPERBARIC BUPIVACAINE COMPARED TO 0.5% HYPERBARIC BUPIVACAINE IN SUBARACHNOID BLOCK IN LOWER LIMB ORTHOPAEDIC SURGERIES: AN OBSERVATIONAL STUDY.

Abstract

Background: Pain is an unkind sensory and sensitive practice associated with actual or potential tissue damage and also is associated with uncomfortable sensations in body. Postoperative pain management holds the key aspect of postoperative care. In this study, we have compared the intrathecal 0.5% hyperbaric bupivacaine with intrathecal fentanyl as adjuvant to 0.5% hyperbaric bupivacaine in terms of safety, efcacy, and postoperative analgesia in patients undergoing lower limb orthopaedic surgeries and also studied the side effects of the drugs used. An Material: analytical, prospective, observational study was conducted in Department of anaesthesia of a tertiary care teaching hospital. All adult patients eligible by the mentioned inclusion and exclusion criteria were considered as sample who were observed and analysed. Total 112 patients were included in the study, which were divided in two equal groups. Group I (BF)- Patients who received 3 ml of 0.5% hyperbaric bupivacaine and 25 μg of fentanyl intrathecally. Group II (B)- Patients who received 3 ml of 0.5% hyperbaric bupivacaine and 0.5 ml of CSF intrathecally. In Results: present study there was no statistical signicant difference in mean age, sex, weight, and ASA grade between two groups. In the study there was statistically signicant difference in mean VAS score between two groups at post op 3rd hrs,4th and 5th hrs. At these intervals mean VAS score was high in group II compared to group I. Mean time of First Rescue Analgesia in group I was 4.85 ± 0.47 hrs and in group II was 3.5 ± 0.53 hrs which highly statistically signicant. There was no statistical signicant difference in side effects amongst the two groups. There was statistically signicant difference in mean HR between two groups at post op 4th and 5th hr. Mean HR was high in group II compared to group I at these two intervals. In the study there was no statistically signicant difference in mean SBP, DBP and MAP between two groups from baseline to post op 6 hrs. Present study concluded that addition of 25 μg fentanyl to intrathecal bupivacai Conclusion: ne offers longer duration of postoperative analgesia. So, it has suggested that fentanyl is a better choice with regards to postoperative analgesia in lower limb orthopaedic surgeries.