Background: Spinal anesthesia is the preferred anesthetic technique for elective cesarean sections due to itssimplicity, rapid onset, and reliability. Bupivacaine is commonly used for spinal anesthesia; however, the additionof intrathecal opioids like fentanyl can improve the quality of anesthesia and analgesia. This study evaluates theeffects of varying doses of fentanyl in combination with bupivacaine on intraoperative anesthesia quality, durationof analgesia, and maternal and neonatal outcomes.Objectives: To compare the efficacy and side effect profile of three different doses of fentanyl (10 μg, 20 μg, and25 μg) when combined with 0.5% hyperbaric bupivacaine in spinal anesthesia for elective cesarean section.Methods: A retrospective observational study was conducted at Patna Medical College and Hospital. Medicalrecords of 135 parturients who underwent elective cesarean section under spinal anesthesia for one year . Patientswere categorized into three groups based on the dose of intrathecal fentanyl used: Group A (10 μg), Group B (20μg), and Group C (25 μg), each with 45 patients. Data regarding sensory and motor block characteristics,intraoperative analgesia, hemodynamic changes, side effects, and neonatal APGAR scores were collected andanalyzed.Results: All three groups achieved adequate surgical anesthesia. Group C had the longest duration ofpostoperative analgesia (mean 245 ± 30 min) compared to Group A (180 ± 25 min) and Group B (215 ± 28 min).Incidence of pruritus and nausea was higher in Group C. Hemodynamic stability and neonatal outcomes werecomparable among all groups.Conclusion: The addition of fentanyl to intrathecal bupivacaine enhances postoperative analgesia in a dose-dependent manner. A dose of 20 μg offers a favorable balance between efficacy and side effects, making it asuitable choice for elective cesarean sections.
Neelam et al. (Thu,) studied this question.