Effect Of Intrathecal Fentanyl Research Articles

Effect of Intrathecal Fentanyl on Haemodynamic Changes in Lower Segment Caesarean Section

Effect of Intrathecal Fentanyl on Haemodynamic Changes in Lower Segment Caesarean Section

COMPARISON OF 1% CHLOROPROCAINE IN SUB-ARACHNOID BLOCK WITH OR WITHOUT FENTANYL FOR ENHANCED RECOVERY AFTER PERIANAL SURGERIES

Objective: Spinal anesthesia is a reliable and safe technique for procedures of lower abdomen, perianal surgeries, and lower limbs. The current availability of short acting local anesthetic agents like preservative free 1% chloroprocaine has renewed the interest for this technique in short- and ultra-short procedures. Opioids continue to be the most commonly added adjuvants in local anesthetics for potentiation of analgesic action. In this study, we investigated the effect of intrathecal fentanyl as an adjuvant to 1% chloroprocaine in patients undergoing perianal surgeries. Methods: This prospective, randomized, and comparative study was conducted in 80 ASA Physical status I and II adult patients (age 20–80 years) undergoing perianal surgeries under spinal anesthesia. Group A patients received 1% chloroprocaine 3 ml (30 mg) and 0.4ml saline and Group B patients received 1% chloroprocaine 3 ml (30 mg) with fentanyl 0.4 ml (20 μg). Primary objectives were duration of analgesia and time to unassisted ambulation. Onset and duration of sensory and motor blockade, maximum height of sensory block, 2 segment regression, hemodynamic parameters, time to voiding, home discharge eligibility, and any side effects were also recorded. Results: There were no significant differences in demographic characteristics and hemodynamic parameters. The duration of sensory block and duration of analgesia were statistically prolonged in Group B than Group A (p<0.001) without affecting recovery from motor block and time to unassisted ambulation. The adverse effects were comparable in both the groups. Conclusion: The addition of fentanyl to 1% chloroprocaine intrathecally prolonged the duration of analgesia and sensory block in patients undergoing perianal surgeries.

Comparison of Intrathecal Midazolam and Fentanyl Added to Bupivacaine for Spinal Anesthesia in Patients Undergoing Appendicectomy

Introduction: Hyperbaric Bupivacaine is the extensively used local anesthetic but the major disadvantage is profound sympathetic blockade leading to hypotension and prolonged duration of motor block. The addition of Fentanyl or Midazolam can provide excellent quality and prolong the duration of analgesia. The study aims to compare the effect of intrathecal Fentanyl with that of intrathecal Midazolam in combination with 0.5% hyperbaric Bupivacaine on the duration and quality of spinal anesthesia in patients undergoing appendicectomy.Materials and Methods: This is a prospective, comparative and interventional study where patients were randomized into two equal groups. The study was conducted in a tertiary referral hospital from July 2018 to December 2018 after ethical approval. Group BF received Fentanyl and group BM received Midazolam The outcomes measured were, peak sensory level, quality of intraoperative analgesia and motor block, duration of effective analgesia, intraoperative and postoperative complications.Results: A total of 44 patients were studied with 22 in each arm. The two groups were comparable in terms of age, weight, height, duration of surgery, and ASA status of the patients. Peak sensory level and degree of motor block were not statistically different in the two arms. Duration of effective analgesia was 293.16±35 min in the BF group and 267.80±32 min in the BM group (p=0.01). Increased incidence of pruritus was recorded during the postoperative period in the Fentanyl group.Conclusions: Fentanyl and Midazolam both are equally effi cient adjuvant added to hyperbaric Bupivacaine for intrathecal use to improve the quality of spinal anesthesia in patients undergoing appendicectomy.

Comparison of Analgesic Effect of Intrathecal Fentanyl & Clonidine with Hyperbaric Bupivacaine in Lower Limb Surgeries

Comparison of Analgesic Effect of Intrathecal Fentanyl & Clonidine with Hyperbaric Bupivacaine in Lower Limb Surgeries

Motor and sensory blocking effect of intrathecal fentanyl versus dexmedetomidine as adjuvants to bupivacaine for cesarean section

Background Intrathecal α2 agonists prolong the duration of action of local anesthetics and reduce the required dose. Dexmedetomidine is an α2 receptor agonist, and its α2/α1 selectivity is eight times higher than that of clonidine. Aim The aim of this study was to determine the effect of adding dexmedetomidine and fentanyl to intrathecal bupivacaine on the onset time and duration and intensity of motor and sensory blocks for cesarean section. Patients and methods The study was carried out on 40 adult female patients who were randomly classified using closed envelope method into two equal groups, with 20 patients in each: group D patients received intrathecally 2.5 ml volume of 10 mg (2 ml) 0.5% hyperbaric bupivacaine and 10 µg dexmedetomidine in 0.5 ml (prepared by diluting 1 ml dexmedetomidine in 5 ml of normal saline), and group F patients received intrathecally 2.5 ml volume of 10 mg (2 ml) 0.5% hyperbaric bupivacaine and 20 µg fentanyl in 0.5 ml (prepared by diluting 2 ml fentanyl in 2.5 ml of normal saline). The aim was to evaluate motor and sensory block. Sensory block assessment: the onset and duration of sensory block was assessed by ice cube method, and time taken from intrathecal injection to the highest level of sensory block and sensory regression to the L1 dermatome were recorded. On achieving T7 sensory blockade level, surgery was allowed. Motor block assessment: onset and degree of motor block was assessed by Bromage scale: 0, no paralysis; 1, inability to raise extended leg; 2, inability to flex the knee; and 3, inability to flex the ankle (complete motor block). Results Sensory and motor block onset times were shorter in group D than in group F. The regression of the sensory block to S1 dermatome and Bromage 0 were longer in group D than group F. The two-dermatome regression time was longer in group D than group F. There was a statistically significant decrease in group F regarding systolic, diastolic, and mean arterial blood pressures and heart rate than group D. There was no statistically significant difference among the two groups regarding arterial oxygen saturation and respiratory rate. Neonatal outcome was normal in all groups. Conclusion Intrathecal dexmedetomidine addition to bupivacaine for spinal anesthesia synergistically increases block duration and shortens sensory and motor block onset time without any significant adverse effects.

Comparison of Effects of Intrathecal Fentanyl versus Dexmedetomidine in Patients undergoing Transurethral Resection of Prostate

Comparison of Effects of Intrathecal Fentanyl versus Dexmedetomidine in Patients undergoing Transurethral Resection of Prostate

Effect of intrathecal fentanyl on incidence of post-spinal headache

Effect of intrathecal fentanyl on incidence of post-spinal headache

The Effects of Intrathecal Fentanyl on Sedation Depth and Postoperative Recovery Room Delirium

Background/Aim. Intrathecal anaesthesia has been shown to increase sedation level. This study aimed to evaluate the effects of intrathecal applied fentanyl with levobupivacaine on intraoperative sedation and recovery room delirium. Materials and Methods. The study included 68 patients, ASA I–III, 55–85 years. One day preoperatively, the Confusion Assessment Method (CAM) and the Mini Mental Status Test (MMST) were applied and patients were separated into two groups. In Group L 2.5 mL levobupivacaine and in Group LF 2 mL levobupivacaine and 0.5 mL fentanyl were applied intrathecally. In a supine position, following a propofol IV 1 mg kg−1 bolus to obtain Bispectral Index (BIS) of 70–85, propofol infusion was started (1 mg kg−1 st−1). With observation of SpO2, BIS, and the Observer Assessment and Alertness/Sedation Scale (OAA/SS) with the haemodynamic values, the total propofol amount was calculated. Evaluations were made of pain severity (VAS), analgesic use, transfusion requirement, and recovery room delirium. Results. In the comparison within the groups, a significant decrease was determined in HR and MAP compared to the initial values (p<0.05). A positive correlation was found between the BIS and OAA/SS values. The amounts of propofol used were similar between the groups. Conclusions. Intrathecal fentanyl and levobupivacaine had the same effect on sedation or BIS and fentanyl did not cause delirium.

Effect of Interathecal Fentanyl on the Characteristic of Spinal Anesthesia for Caesarean Section

The study was conducted to analyze the effect of intrathecal fentanyl on the characteristics of spinal anesthesia for caesarean section. The study was conducted over 60 selected uncomplicated full term pts. admitted for caesarean section. In group A-20 Pts. were given 15 μgm fentanyl with bupivacaine.

Effects of intrathecal fentanyl on quality of spinal anesthesia in children undergoing inguinal hernia repair

The effect of intrathecal fentanyl on the characteristics of spinal anesthesia has not been investigated in children undergoing inguinal hernia repair. The purpose of this study was to assess whether the incidence and severity of pain during peritoneal sac traction is decreased by addition of fentanyl to bupivacaine in children undergoing inguinal hernia repair with spinal anesthesia. Children (6-14 years) were randomized into two groups. Group F (n = 25): hyperbaric bupivacaine plus 0.2 microg.kg(-1) of fentanyl. Group P (n = 25): hyperbaric bupivacaine plus 0.9% NaCl (placebo). The dose of bupivacaine was 0.4 mg.kg(-1). The primary variable was the incidence and severity of pain during peritoneal sac traction. Spinal block characteristics, duration of spinal anesthesia assessed by recovery of hip flexion and duration of analgesia were the secondary variables measured, and the side effects were noted. There were significant differences in incidence of pain and pain scores during sac traction with lower incidence and scores in the fentanyl group (P = 0.009). Two groups were similar regarding the level of sensory block during sac traction and duration of spinal anesthesia. Duration of spinal analgesia was prolonged significantly in the fentanyl group (P = 0.025). Intrathecal fentanyl at a dose of 0.2 microg.kg(-1) added to bupivacaine significantly improves the quality of intraoperative analgesia and prolongs postoperative analgesia in children undergoing inguinal hernia repair with spinal anesthesia.

The Effect of Intrathecal Fentanyl Added to Hyperbaric Bupivacaine on Maternal Respiratory Function during Cesarean Section

The Effect of Intrathecal Fentanyl Added to Hyperbaric Bupivacaine on Maternal Respiratory Function during Cesarean Section

The effect of intrathecal fentanyl added to hyperbaric bupivacaine on maternal respiratory function during Cesarean section

The effect of intrathecal fentanyl added to hyperbaric bupivacaine on maternal respiratory function during Cesarean section

The effects of intrathecal fentanyl in transurethral resection of prostat syndrome surgery under spinal anaesthesia

The effects of intrathecal fentanyl in transurethral resection of prostat syndrome surgery under spinal anaesthesia

Effects of intrathecal fentanyl on duration of levobupivacaine for lower limb surgery

Effects of intrathecal fentanyl on duration of levobupivacaine for lower limb surgery

The effects of intrathecal fentanyl in transurethral resection of prostat syndrome surgery under spinal anaesthesia

The effects of intrathecal fentanyl in transurethral resection of prostat syndrome surgery under spinal anaesthesia

Effects of intrathecal fentanyl on duration of levobupivacaine for lower limb surgery

Effects of intrathecal fentanyl on duration of levobupivacaine for lower limb surgery

Effects of Intrathecal Fentanyl on Bupivacaine Spinal Blockade for Urologic Surgery

Background: Opioids are increasingly being administered intrathecally as adjuncts to local anesthetics. They enhance spinal anesthesia without prolonging motor recovery. We evaluated the effect of 10 of fentanyl to bupivacaine on sensory, motor block and side effects. Methods: Thirty six patients undergoing urologic surgery were randomized into two groups. Control group received bupivacaine 10 mg combined with normal saline 0.2 ml, and Fentanyl group received bupivacaine 10 mg with fentanyl 10 (0.2 ml). Results: There were no significant differences between two groups in the peak level of sensory block, onset of peak level, duration of motor block, and side effects. However, the time of regression from peak level to T10 in Fentanyl group was longer significantly than that of Control group. Conclusions: Intrathecal small dose fentanyl (10) on bupivacaine spinal blockade prolonged duration of sensory block and did not augment side effects and provide reliable anesthesia for urologic surgery.

Minimum Local Analgesic Dose of Intrathecal Bupivacaine in Labor and the Effect of Intrathecal Fentanyl

Minimum Local Analgesic Dose of Intrathecal Bupivacaine in Labor and the Effect of Intrathecal Fentanyl

Effect of intrathecal fentanyl on oxytocin secretion in pregnant women not in labour

Effect of intrathecal fentanyl on oxytocin secretion in pregnant women not in labour

Effect of intrathecal fentanyl on oxytocin secretion in pregnant women not in labour

We studied the effects of spinal intrathecal fentanyl on oxytocin secretion in 20 healthy women prior to an elective caesarean delivery at term under spinal anaesthesia. The women were randomly allocated into two groups with respect to spinal anaesthesia. Group I (n=10) received intrathecal bupivacaine (15 mg) plus fentanyl (25 microgram), and Group II (n=10) received intrathecal bupivacaine (15 mg) alone, prior to caesarean section. The two groups were comparable demographically. Altogether, ten samples of 4.5 ml of blood (taken every 60 s) were obtained before and ten samples were obtained after the intrathecal administration of the drug and establishment of the T6 block, and plasma oxytocin concentrations were assayed for each subject. Oxytocin was measured by RIA. We found no significant differences in plasma oxytocin concentrations of individual subjects before and after intrathecal injection. In addition, there were no significant differences in plasma oxytocin concentrations between the two groups when pooled samples from the subjects were compared for the pre- and post-intrathecal injection phases. We conclude that the spinal intrathecal administration of fentanyl does not suppress oxytocin secretion in pregnant women who are not in labour at term.