Background and Aim: Pregnant woman are more sensitive to local anaesthetics during caesarean section. The aim of this prospective, double blind randomized controlled study was to compare two different low doses of intrathecal bupivacaine & fentanyl mixture in caesarean section and to see relevance of preloading in them to maintain stable hemodynamics and provide better analgesia with minimal complications.

Materials and Method: 200 parturient scheduled for caesarean section were randomly allocated into 2 groups of 100 patients each and a subgroup of 50 patients.Group1A (0.5% Hyperbaric Bupivacaine 7.5mg+25µg fentanyl with preloading colloid 10ml/kg), Group1B (0.5% Hyperbaric Bupivacaine 7.5mg+25µg fentanyl  without preloading), Group2A (0.5% Hyperbaric Bupivacaine5mg+25µg fentanyl +0.5ml NS with preloading colloid 10ml/kg) and Group2B (0.5% Hyperbaric Bupivacaine5mg+25µg fentanyl+0.5ml NS without preloading).Maternal hemodynamics, duration of sensory and motor analgesia, total duration of analgesia and apgar score of the new born were compared between the groups and analysed by SPSS software using anova and student t test.

Result: Hemodynamic status was more stable in group-2 with less significant fall in mean blood pressure. Surgical anaesthesia was of equal quality in both and apgar score was≥9 in both the groups. Total duration of analgesia in group 1A was 182.64±11.45, group 1B was 180.42±12.93, group 2A was 154.04±10.56 and group 2B was 156.02±9.43.So, the total duration of analgesia which was assessed by VAS was excellent in the group 1.

Conclusion: As we are taking caesarean section in our study which takes maximum upto 40-50 min. So the combination of diluted low-dose bupivacaine and fentanyl could provide more stable hemodynamic status, without compromising required surgical anaesthesia and minimum complications to mother with no foetal compromise.

Keywords: Spinal-anaesthesia, local-anaesthetic, fentanyl, caesarean-section.

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Deepika Meena

Resident, Department of Anaesthesia,

Sardar Patel Medical College & AGH, Bikaner, Rajasthan

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