Publication:

A comparative study on the block characteristics in spinal anaesthesia with premixed or succedent administration of hyperbaric bupivacaine and fentanyl in lower segment caesarean section

Background Caesarean section (CS) is a lifesaving procedure when there is both or either maternal and fetal problem and the rate of CS had increased dramatically. Objectives were to compare between premixed and succedent administration of intrathecal hyperbaric Bupivacaine and Fentanyl on the block characteristics of spinal anesthesia among parturient women undergoing lower segment CS.

Methods The study groups divided into two. The total sample size was 60, 30 patients in each group. In group A, all the patients were given 2 ml of hyperbaric Bupivacaine (0.5%) using a 5 ml syringe followed by 0.5 ml (25 mcg) Fentanyl citrate in a 2 ml syringe intrathecally at L3-4 space and in the group B, all the patients were given 2 ml of hyperbaric Bupivacaine (0.5%) plus 0.5 ml (25 mcg) Fentanyl citrate premixed in a 5 ml syringe intrathecally at L3-4 space.

Results The mean time of onset of sensory block was significantly shorter in group A when compared to group B. The time to achieve maximum sensory block level and time to complete motor blockade was significantly shorter in group A when compared to group B. There was no significant difference between the groups in terms of hemodynamic changes and attainment of maximum sensory block levels and requirement of vasopressor.

Conclusions There were no significant differences in the time to reach sensory block level T6, degree of motor blockade, Apgar score and complications. The time to achieve maximum sensory block level was significantly shorter in group A when compared to group B.