Intrathecal low–dose levobupivacaine and bupivacaine combined with fentanyl in a randomized controlled study for caesarean section in I.Q City Medical College and multispecialty hospital

Dr. Dilip Kumar Bhowmik; Prof. (Dr.) Mohammad Zakiuddin

Volume : X, Issue : II, February - 2020

Intrathecal low–dose levobupivacaine and bupivacaine combined with fentanyl in a randomized controlled study for caesarean section in I.Q City Medical College and multispecialty hospital

Dr. Dilip Kumar Bhowmik, Prof. Dr. Mohammad Zakiuddin

Abstract :

BACKGROUND: Intrathecal combination of local anaesthetic with opioids produces a synergistic effect without intensifying motor and sympathetic blockades. It also enables successful Anaesthesia with use of a low dose of local anaesthetic, which also results in more stable hemodynamics. AIMS AND OBJECTIVE: To compare the onset and duration of action, levels of sensory and motor blocks and side–effects of equal doses of hyperbaric bupivacaine and levobupivacaine with Intrathecal fentanyl addition in spinal technique in elective cesarean cases. METHODS AND MATERIAL: Seventy–two patients undergoing caesarean section with spinal Anaesthesia received low–dose 0.5% levobupivacaine (7 mg) plus fentanyl 25 µg (group A) or low–dose 0.5% bupivacaine (7 mg) plus fentanyl 25 µg (group B). The time to achieve sensory blockade of T6, the maximum spread of sensory blockade, time to S2 regression, sensorial blockade levels and motor blockade at the beginning and end of surgery were the parameters assessed. Hemodynamic parameters systolic and diastolic blood pressures, heart rate were recorded, as side–effects. CONCLUSION: Intrathecal isobaric levobupivacaine–fentanyl combination is a good alternative to hyperbaric bupivacaine–fentanyl combination in cesarean surgery as it is less effective in motor block, it maintains hemodynamic stability at higher sensorial block levels.