Efficacy Of Lower Doses Of Hyperbaric Bupivacaine With Opioid Adjuvant In Elective Cesarean Delivery: An Observational Study

ABSTRACT

Background and aims:Hemodynamic stability following spinal anaesthesia in caesarean delivery may be achieved with lower dose of the drug at the expense of surgical condition which is not desired. So this study was performed to observe whether good surgical condition would be achieved with lower doses of hyperbaric bupivacaine with fentanyl adjuvant during elective caesarean delivery with minimum complications. Methods: After obtaining institutional ethics committee clearance and written informed consent, this prospective observational study was performed among 110 patients,aged between 18-38 years with singleton term pregnancy scheduled for elective caesarean delivery.The study population was randomly divided into 2 equal groups. Group A and Group B patients received 7.5 mg and 10 mg hyperbaric bupivacaine with fentanyl 25 mcg respectively. The onset and duration of sensory and motor block, the time to reach maximum block height, duration of analgesia, intraoperative average mean arterial pressure, heart rate, Apgar score and complications. Data were analyzed using Microsoft excel 2010 and statistical package of social sciences (SPSS) software version 23.The unpaired Student's t-test was used and p value < 0.05 was considered as statistically signicant. Results: The onset of sensory and motor block, the time to reach peak sensory block, the duration of analgesia and motor block in Group B were statistically signicant than Group A. (p value 0.000).Muscle relaxation was adequate in the both groups. There were signicant fall of average mean arterial blood pressure at 5 and 10 minutes following spinal anaesthesia but subsequent values were comparable. The incidence of complications wasminimum in the both groups. Conclusion: The 7.5 mg hyperbaric bupivacaine with 25 mcg fentanyl provides good surgical condition, hemodynamic stability with minimum complications during elective caesarean delivery.