ABSTRACT
Background: Epidural analgesia is the most commonly used method for labour analgesia. Aims & Objective: To evaluate the safe dose of fentanyl added to Bupivacaine 0.125% and its effect on quality and duration of analgesia with side-effects. Materials and Methods: Forty-five healthy nulliparous women, ASA physical status I and II with an uncomplicated pregnancy and single fetus in vertex position were given lumbar epidural analgesia. Patients in Group A (n=15) received Bupivacaine 0.125 percent; Group B (n=15) and C (n=15) received the same agents as Group A but with addition to the initial dose of 2 mcg/ml or 4 mcg/ml of fentanyl respectively. All the patients were evaluated for duration and quality of analgesia, duration of labour, method of delivery and side effects. Results: Addition of either 2 mcg/ml or 4mcg/ml of fentanyl resulted in longer duration of analgesia (132.2 ± 12.4 minutes and 188.20 ± 18.5 minutes respectively versus 92.5 ± 10.2 minutes) and also decreased number of top up doses significantly. Quality of analgesia was better in Group B and Group C as compared to Group A. Addition of fentanyl did not affect the duration of labour, the method of delivery and fetal outcome. Conclusion: Combination of Fentanyl 2 mcg/ml and Fentanyl 4 mcg/ml with Bupivacaine 0.125% is both and safe for providing labour analgesia via epidural route.
ABSTRACT
Background: Subarachnoid block is commonest anaesthetic technique used for most gynaecological surgeries. Local anaesthetic agents have traditionally been used for this, but with the discovery of opioid receptors in spinal cord in substantia gelatinosa. Possibility of synergism between opioids & local anaesthetics co-administered intrathecally has been explored for various lower abdominal surgeries. Aims & Objective: To study was to compare effect of intrathecal bupivacaine with bupivacaine, fentanyl mixture to assess safety and efficacy, peri –operative hemodynamic stability postoperative pain relief in major gynecological surgeries. Materials and Methods: 60 female patients with American society of anaesthesiologists (ASA) grade I OR II were divided in two groups after matching. Group BF received inj. Bupivacaine 15 mg (0.5%) 3 ml + inj. Fentanyl 25 mcg, (50 mcg/ml), 0.5 ml and Group B: (inj. Bupivacaine 15 mg (0.5%) 3 ml + Normal Saline (0.5 ml), total volume was 3.5 ml in each group. Spinal anaesthesia was given with conventional technique. Results: Duration of sensory block and effective analgesia was prolonged while there was no change in duration of motor block with intrathecally bupivacaine with fentanyl as compared to inj. Bupivacaine alone. Conclusion: Intrathecal Fentanyl as an adjuvant to bupivacaine improves quality of block with longer duration of sensory block & prolongs duration of effective analgesia.