A study of comparative evaluation of bupivacaine plain versus bupivacaine with fentanyl in spinal anaesthesia in orthopedic surgery

Uma Shankar Gupta; Mayur Gupta

Volume : VIII, Issue : V, May - 2018

A study of comparative evaluation of bupivacaine plain versus bupivacaine with fentanyl in spinal anaesthesia in orthopedic surgery

Uma Shankar Gupta, Mayur Gupta

Abstract :

synergistic analgesic effect, enhancing the sensory blockade without altering the degree of sympathetic blockade ensuring better hemodynamic stability. The addition of Fentanyl to hyperbaric Bupivacaine increases the intra–operative quality of subarachnoid block and synergistic anti–nociceptive effects with local anesthetics.The study was done to compare effects of addition of Fentanyl to Bupivacaine in spinal anesthesia for orthopedic lower limb surgeries.

Method: The prospective randomized study was conducted in 60 ASA I/II adult patients, aged 18–60 years undergoing lower limb orthopedic surgeries. Patients were given spinal anesthesia and randomly divided in to 2 groups (n=30). Group A (conventional dose– 3 ml of Bupivacaine 0.5%) and Group B (low dose– 2.5 ml Bupivacaine + 0.5 ml Fentanyl).

Result: Addition of Fentanyl to low dose Bupivacaine prolongs the duration of sensory block and does not alter the characteristics of motor block, reduces intra–operative discomfort and produces more post–operative analgesia, more hemodynamic stability and lower incidence of complications (e.g. shivering) than conventional dose of 0.5% plain Bupivacaine.

Conclusion: We concluded that subarachnoid block with 2.5cc Bupivacaine 0.5% and 25 µg fentanyl is a more safer and better option, both in terms of maintaining hemodynamic stability and lower incidence of complications without compromising the surgical conditions for patients undergoing lower limb orthopedic surgeries.