Key result
Intrathecal bupivacaine combined with fentanyl prolonged the duration of sensory spinal block and analgesia compared to bupivacaine alone in 50 parturients with pregnancy-induced hypertension.
Why the study?
Does intrathecal bupivacaine combined with fentanyl improve analgesia and sensory block compared to bupivacaine alone in parturients with pregnancy-induced hypertension undergoing Caesarean section?
RCT (n=50)
Does intrathecal bupivacaine combined with fentanyl improve analgesia and sensory block compared to bupivacaine alone in parturients with pregnancy-induced hypertension undergoing Caesarean section?
Adding fentanyl to intrathecal bupivacaine improves the duration and quality of analgesia without adverse hemodynamic or fetal effects in patients with pregnancy-induced hypertension undergoing Caesarean section.
May support fentanyl adjunct in PIH cesarean spinals; leaves open confirmation in randomized trials.
Neuraxial administration of opioid’s along with local anesthetics improve the quality of intraoperative analgesia and also provides postoperative pain relief for longer duration. The present study was conducted to study and compare the effects of bupivacaine alone and its combination with fentanyl used intrathecally in parturients with PIH. 50 ASA grade II patients with PIH defined as blood pressure between 140-160/ 90-110 mmHg without proteinuria were selected and divided into 2 groups as Group (I)-Bupivacaine and Group (II)BupivacaineFentanyl group. Haemodynamic variables like systolic and diastolic blood pressure, heart rate were recorded every 2 minutes upto delivery of baby and then every 5 minutes until end of surgery. Sensory block and motor block alongwith side effects were recorded. Pain was evaluated using visual analogue scale and neonatal outcome assessed using APGAR scoring. The highest sensory level achieved in bupivacaine-fentanyl group was higher than in the group receiving plain bupivacaine. The time taken for sensory regression to T12 and duration of analgesia was longer in the Bupivacaine-Fentanyl group. We conclude the combination group prolongs the duration of sensory spinal block, increases the duration of analgesia without increasing the duration of motor block, does not cause any significant side effects and provides stable haemodynamic conditions without fetal or maternal compromise.
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A 2012 study conducted an RCT in Pregnancy Induced Hypertension (n=50). Bupivacaine and Fentanyl vs. Bupivacaine alone was evaluated on Duration of sensory spinal block and analgesia. Intrathecal bupivacaine combined with fentanyl prolonged the duration of sensory spinal block and analgesia compared to bupivacaine alone in 50 parturients with pregnancy-induced hypertension.
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