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A STUDY TO DETERMINE THE EFFECTS OF INTRATHECAL FENTANYL COMBINED WITH 0.5% BUPIVACAINE (HYPERBARIC) FOR SUBARACHNOID BLOCK ON THE DURATION AND QUALITY OF POST-OPERATIVE ANALGESIA
Moses Charles Dsouza, Rahul Fernandez, Sumithra Selvam BACKGROUND
Spinal anaesthesia with hyperbaric Bupivacaine Hydrochloride has been popular for surgical procedures. The need to intensify and
increase duration of sensory blockade without affecting motor blockade has led to the addition of fentanyl, thus prolonging the
duration of post-operative analgesia. Aim of this study is to assess the duration and quality of post-operative pain relief when
Hyperbaric Bupivacaine Hydrochloride is combined with fentanyl for sub-arachnoid block and also to study the prolongation of
motor and sensory blockade.
MATERIALS AND METHODS
75 patients were randomly allocated into the following three groups Group A received SAB with 2.5 ml of 0.5% Bupivacaine
Hydrochloride (Hyperbaric) Group B received SAB with addition of 10g fentanyl to 2.5 ml of 0.5% Bupivacaine Hydrochloride
(Hyperbaric). Group C received SAB with addition of 25g fentanyl to 2.5 ml of 0.5% Bupivacaine Hydrochloride (Hyperbaric).
RESULTS
Mean duration of analgesia was increased with addition of fentanyl with 0.5% hyperbaric Bupivacaine intrathecally. Mean duration
of analgesia was statistically highly significant in the fentanyl groups. The total dose of analgesics given in the postoperative period
was highest in group A which was statistically significant. Times for two segment regression of sensory level were prolonged in
group B and group C thus increasing the duration of sensory analgesia. Time to full motor recovery was not delayed in any of the
three groups. The haemodynamic changes were similar in all the three groups with minimal changes in pulse rate and systolic
blood pressure.
CONCLUSION
The addition of intrathecal fentanyl to the local anaesthetic injected intrathecally in subarachnoid block prolonged sensory
analgesia obtained by the block without hampering recovery from motor block or causing untoward haemodynamic disturbances.
Dose of 10 g fentanyl provided all these benefits which were accentuated by increasing the dose to 25g. Hence a dose of 10 g to
25 g as deemed fit is useful for this purpose.
