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During spinal anesthesia for cesarean delivery, adding Fentanyl with lower dose of Bupivacaine may offer comparable anesthesia with longer postoperative analgesia and decreased risk of hypotension.
An institutional-based prospective cohort study recommended the use of 25 mcg intrathecal Fentanyl as an adjuvant with 8 mg Bupivacaine to enhance hemodynamic status and improve postoperative analgesia in parturients undergoing elective cesarean section under spinal anesthesia. This study aimed to compare analgesic and hemodynamic effects of analgesic Fentanyl as an adjuvant with low and conventional doses of local anesthetic Bupivacaine in 90 pregnant mothers undergoing cesarean.
Using chart review, intraoperative observation, and postoperatively patient interview, collection of data was done. With the aid of one-way ANOVA, chi-square, and Kruskal Wallis H rank test, data was entered into EPI INFO and transported to SPSS version 23 for assessment of variables. Hypotension but not bradycardia, was considerably frequent in the conventional dose of Bupivacaine alone (CB) group and a conventional dose of Bupivacaine + Fentanyl (CBF) groups when compared to the lower dose of Bupivacaine + Fentanyl (LBF) groups.
Duration of analgesia and time for the first analgesic request was significantly longer in LBF and CBF groups when compared to CB group, as shown in Table 1:
Bupivacaine's lower dose was linked with prompt recovery and reduced risk of hypotension. Fentanyl in conjunction with a reduced dose of Bupivacaine in spinal anesthesia for cesarean delivery could offer comparable anesthesia along with benefits like minimized risk of hypotension and extended postoperative analgesia.
PLOS One
Hemodynamic and analgesic effect of intrathecal fentanyl with bupivacaine in patients undergoing elective cesarean section; a prospective cohort study
Ayub Mohammed Ebrie et al.
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