A Clinical Study of Effect of Spinal Fentanyl on Subarchnoid Block in Parturients

BACKGROUND & OBJECTIVES: Subarchnoid block (SAB) is commonly employed for cesarean delivery. The use of opioids has gained widespread popularity as they augment the analgesia produced by local anaesthetic through direct binding with specific receptors. Hence the present study was undertaken to study the effects of spinally administered fentanyl 12.5g on the onset and duration of 2 ml of 0.5% bupivacaine (H) induced sensory and motor subarchnoid block, quality of intraoperative surgical anaesthesia and requirements of analgesia during early postoperative period. MATERIAL & METHODS: Ninety healthy parturients of ASA Grade I and II scheduled for elective caesarean section(LSCS) were randomly allocated to receive either 2ml of 0.5% Bupivacaine (H) with 0.25 ml of CSF (Group BC n = 45) or 2 ml of 0.5% bupivacaine (H) with 0.25 ml 12.5g fentanyl (Group FB n = 45). Parturients were pre-loaded with 0.5 L of Ringer lactate and premedicated with in metoclopromide 10mg and. ranitidine 50mg IV. Vital signs, sensory level, motor block, pain score and side effects were observed every 120 seconds for first 10 minutes, then at 15minutes for 1 ST hour, thereafter at 0.5 hours interval until the patient complained of pain. OBSERVATIONS: Time of onset of sensory analgesia was rapid in Group FB. Time for two segment regression, time for sensory regression to L1 and time for complete sensory recovery was prolonged in Group FB. The total duration of analgesia was prolonged in Group FB, i.e. 259.432.53 minutes when compared to Group BC, i.e. 165 29.8 minutes. DISCUSSION & CONCLUSION: This study indicated that 12.5g of fentanyl added to 2ml of 0.5% bupivacaine (H) (H) for subarchnoid block would markedly improve intraoperative anaesthesia, and reduced the demand for postoperative analgesic with good maternal satisfaction and foetal well-being.