Why the study?
Upper abdominal surgery is increasingly performed on outpatients under spinal anaesthesia, creating a need to evaluate drug combinations that reduce hospital stay with minimal side effects.
Does the addition of intrathecal fentanyl to bupivacaine improve the recovery profile and postoperative analgesia compared to bupivacaine alone in patients undergoing upper abdominal surgery?
Does the addition of intrathecal fentanyl to bupivacaine improve the recovery profile and postoperative analgesia compared to bupivacaine alone in patients undergoing upper abdominal surgery?
Adding 25 µg of fentanyl to intrathecal bupivacaine for upper abdominal surgery prolongs analgesia and reduces the need for postoperative pain supplementation, despite increasing voiding time.
Answers are grounded in this paper and cite their sources.
Supports adding intrathecal fentanyl to bupivacaine for upper abdominal surgery; extends RCT evidence on spinal opioid adjuvants.
Knowledge of the recovery profile from a spinal anaesthetic is helpful in predicting time to meeting discharge criteria from an ambulatory surgery center. Upper abdominal surgery takes 2 to 3 hours. Which was previously considered inappropriate for the ambulatory setting, surgery is now being performed on outpatients under spinal anaesthesia. Therefore, it is important for anaesthesiologists to know the recovery profile of Bupivacaine and Bupivacaine with Fentanyl. There is always need of search of such a drug combination which reduces the hospital stay of patient with minimal side effects. This study explores the use of long acting local anaesthetic Bupivacaine and Bupivacaine with Fentanyl for upper abdominal surgery. METHODS 120 patients undergoing upper abdominal surgery were enrolled in a double-blinded clinical trial study. Patients were randomly allocated into two groups. Group A received 17.5 mg (3.5 ml) of Bupivacaine and Group B received Bupivacaine 15 mg and 25 g of Fentanyl (3.5 ml) as intrathecal drug for spinal anaesthesia. Sensory and motor blockade scores, postoperative pain scores and need of analgesic injection 6 and 12 hours after surgery, postoperative voiding time, and the incidence of hypotension, bradycardia, respiratory depression, and nausea and vomiting were recorded. Ambulation time and discharge from hospital were also recorded.
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Usmani et al. (2019) studied this question.
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