TO STUDY THE EFFICACY (DIFFERENTIAL BLOCK) OF INTRA– THECAL FENTANYL IN PROLONGING THE POST –OPERATIVE ANALGESIA WHEN ADDED TO HYPERBARIC BUPIVACAINE IN CAESAREAN SECTION

Dr TEJAVATH PADMA; Dr SOWJANYA; Dr ALBEENA; Dr RAJU B

Volume : IX, Issue : III, March - 2020

TO STUDY THE EFFICACY (DIFFERENTIAL BLOCK) OF INTRA– THECAL FENTANYL IN PROLONGING THE POST –OPERATIVE ANALGESIA WHEN ADDED TO HYPERBARIC BUPIVACAINE IN CAESAREAN SECTION

Dr Tejavath Padma, Dr Sowjanya, Dr Albeena, Dr Raju B

Abstract :

BACKGROUND: Spinal anesthesia is commonly employed for caesarean delivery. However intra–thecal bupivacaine alone may be insufficient to provide complete analgesia despite the high sensory block. Patient had visceral pain even after intra–thecal administration of 15 mg of bupivacaine.Further more such large doses of intra–thecal bupivacaine were associated with severe hypotension and delayed recovery of motor block.Therefore smaller doses of bupivacaine supplemented by intra thecal Opioids have been recommended for spinal anesthesia in parturients undergoing caesarean section delivery. Aim and objectives : To provide best intra–opertive and post–operative analgesia. To clinically evaluate the efficacy (differential block) and side effects of intra–thecal fentanyl in prolonging the post –operative analgesia when added to hyperbaric bupivacaine in caesarean section. Methods: After obtaining institutional ethical and scientific committee approval, we conducted the study in 60 patients, who were in ASA grade 1 and 2, aged between 19Y –55 Y posted for emergency and elective LSCS from August 2018 to August 2019. Who were divided into 2 groups 1& II , and both the groups received spinal using 26 G spinal needle at the level of L3–L4. Following which both the groups were monitored for onset ,duration and quality of neuraxial block in both the groups. In post operative period Severity of the pain was measured by visual analouge pain scale score (1–10). RESULTS: Time for two segment regression, time for sensory regression to L1 and time for complete sensory recovery was significantly prolonged in bupivacaine with fentanyl combination when compared to bupivacaine alone. CONCLUSION: Intrathecal fentanyl with Bupivacaine provide early onset, prolonged anesthesia and analgesia than Bupivacaine alone with acceptable side effects.