RESUMO
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.
RESUMO
Background: Post dural puncture headache (PDPH) is a serious complication of spinal anaesthesia and incidence is more particularly in parturient. Aims & Objective: The present study was designed to investigate the use of 27 Gauge (G) spinal needle for spinal anaesthesia in Caesarean section in terms of success and PDPH rate. Material and Methods: We included total 50 female patients of aged 20-40 years old, were administered spinal anaesthesia with 27G Quincke spinal needle for Caesarean section by same investigator having enough experience. Redirections and attempts for lumbar puncture, success rates of spinal anaesthesia and PDPH were recorded. Results: We succeeded in 49 patients (98%) to administer spinal anaesthesia. The mean attempt and redirections for lumbar puncture were 1.1 and 1.24 respectively. We found PDPH in 1 patient (2%), which was mild in severity and subsided within two days. Conclusion: Spinal anaesthesia using a 27G Quincke spinal needle, in experienced hands can have successful spinal block with reduced PDPH rates in patients undergoing Caesarean section.