Intrathecal Administration of Fentanyl with Hyperbaric Bupivacaine either a Mixture or Sequentially in Elective Cesarean Section: A Randomised Single Blind Study

Kanwariya, Anita; Khatri, Chanda; Janweja, Sarita

doi:10.7860/jcdr/2020/43916.13753

Cited by 2 publications

(3 citation statements)

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“…In this study, we found that there was significant reduction in intra operative mean arterial blood pressure at 5th, 10th and 15th min in the M − group compared to the S- group. But there was no significant difference between the groups at 30th min, 45th min, 1st, 2nd, 3rd, and 4th hr after spinal anesthesia which is in line with another study [ 25 ]. A similar result was reported by Amraly and his colleagues showed that early hypotension occurred in group M as compared to group S and also found that frequency of drop in mean arterial blood pressure in group S was lower as compared to the group M(p < 0.05) [ 5 ].…”

Section: Discussionsupporting

confidence: 90%

“…However, there was significant difference on the median of the maximum level of sensory block between M-group and S-group T5 (T5-T6) vs T6 (T5-T7) respectively. (p = 0.06) which is in line with another study stating that time to highest level of both sensory and motor was significantly high in M group compared with S group [ 25 ]. However, another studies conclude that there was no significant difference between groups [ 21 , 27 ].…”

Section: Discussionsupporting

confidence: 90%

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Comparison of sequential versus pre mixed administration of intrathecal fentanyl with hyperbaric bupivacaine for patients undergoing elective Caesarean section at Zewditu memorial referral hospital: A prospective cohort study

Chekole¹,

Kassa

Yadeta

et al. 2022

Annals of Medicine &Amp; Surgery

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Background Spinal anesthesia (SA) is the method of choice for surgery below umbilicus like elective cesarean section. However, Spinal anesthesia is associated with hypotension and limited analgesia duration. To minimize those complications adding opioids like fentanyl either sequentially with separate syringe or pre mixed with local anesthetics become common practice. Objective To compare the hemodynamic and analgesic effect of sequential versus pre mixed injection of intrathecal fentanyl with hyperbaric bupivacaine for patients who underwent elective CS under Spinal anesthesia. Method A prospective cohort study was performed on parturient who undergone elective cesarean section from 01 January 2020 to 30 March 2020. The decision to give either sequential or premixed drug was based on the responsible anesthetists. Sixty-six American society of Anesthesiologist Ⅱ age ≥18 was recruited. Those who received sequentially were grouped as (S- group) and those who had received pre mixed technique were grouped as (M-group). Data were entered into Epi Info version 7.0 and transported into SPSS Version 22 for analysis. Based on normality assumption, analysis was done by independent t -test for normally distributed data. Whereas Mann –Whitney U test for non-normally distributed data and x2 (Chi-square) test for categorical variable. P-value <0.05 was considered as statistically significant. Result Significant reduction in intra operative mean arterial blood pressure was seen in premixed group compared to Sequential group until 15th minute immediately after spinal anesthesia. Thus, the incidence of hypotension was higher in M − group compared to S- group, (p < 0.05). The median Postoperative pain VAS score was significantly lower in the S - group compared to M − group of 4th, 5th and 6th hr. The mean time for 1st rescue analgesic request time was prolonged in the S - group compared to M − group (287.909 ± 15.255 vs. 261.39 ± 25.378) min respectively (p < 0.001). Conclusion The Sequential intrathecal injection of fentanyl and hyperbaric bupivacaine provided significant improvement in the blood pressure stability and of sensory and motor block compared to premixed groups.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Comparison of sequential versus pre mixed administration of intrathecal fentanyl with hyperbaric bupivacaine for patients undergoing elective Caesarean section at Zewditu memorial referral hospital: A prospective cohort study

Chekole¹,

Kassa

Yadeta

et al. 2022

Annals of Medicine &Amp; Surgery

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“…Ummenhofer et al compared the pharmacokinetics of intrathecal opioids and found that fentanyl compared to sufentanyl spreads in the epidural space and gets cleared more rapidly due to its high volume of distribution [ 13 ]. Hence, the spread of hyperbaric bupivacaine in intrathecal space is affected by the co-administration of fentanyl as it alters the baricity of the solution and affects the sensory and motor block characteristics [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Subarachnoid Block Characteristics Following Co-administration of Fentanyl Premixed With Hyperbaric Bupivacaine Versus Antecedent or Succedent to Hyperbaric Bupivacaine: A Randomized Controlled Study

Saxena,

Bharadwaj,

Verma

et al. 2024

Cureus

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Background Adjuvants are often used during subarachnoid block to enhance and prolong the analgesia and decrease the adverse effects of high doses of local anesthetic agents. Intrathecal fentanyl premixed with hyperbaric bupivacaine has been used in spinal anesthesia and compared with the sequential use of these drugs in separate syringes. However, given the paucity of literature, we conducted this study where premixed antecedent and succedent administration of intrathecal fentanyl with hyperbaric bupivacaine were compared in terms of flow dynamics, block characteristics, and hemodynamic alterations. Methodology This prospective, randomized, triple-blinded comparative study was conducted among 160 patients who were randomly allocated into four groups. Group A (n = 40) (control) received 3.0 mL (15 mg) of 0.5% hyperbaric bupivacaine and 0.5 mL of normal saline via a 5.0 mL syringe. Group B (n = 40) received 3.0 mL (15 mg) of 0.5% hyperbaric bupivacaine and 0.5 mL (25 µg) of fentanyl premixed via a single 5.0 mL syringe. Group C (n = 40) received 0.5 mL (25 µg) of fentanyl via a 1.0 mL syringe followed by 3.0 mL (15 mg) of 0.5% hyperbaric bupivacaine via a 5.0 mL syringe. Group D (n = 40) received 3.0 mL (15 mg) of 0.5% hyperbaric bupivacaine via a 5.0 mL syringe followed by 0.5 mL (25 µg) of fentanyl via a 1.0 mL syringe. The onset and regression of sensory and motor blockade, hemodynamic parameters, time to first rescue analgesia, and adverse events were observed. Data analysis was done using SPSS version 17.0 (SPSS Statistics Inc., Chicago, IL, USA). Results The mean time taken for the onset of sensory and motor blockade was least in Group D followed by Group C. Duration of sensory and motor blockade was prolonged in Group D. Patients in Group A experienced more hypotension than Groups B, C, and D. Requirement of rescue analgesia was delayed in Groups C and D. Conclusions Administering 25 µg (0.5 mL) of Fentanyl separately after 15 mg (3.0 mL) of 0.5% hyperbaric bupivacaine results in early onset and prolonged duration of sensory and motor blockade, intraoperative hemodynamic stability, the delayed requirement of rescue analgesia postoperatively, and fewer side effects compared to its co-administration as a premixed solution or antecedent to hyperbaric bupivacaine.

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Intrathecal Administration of Fentanyl with Hyperbaric Bupivacaine either a Mixture or Sequentially in Elective Cesarean Section: A Randomised Single Blind Study

Cited by 2 publications

References 0 publications

Comparison of sequential versus pre mixed administration of intrathecal fentanyl with hyperbaric bupivacaine for patients undergoing elective Caesarean section at Zewditu memorial referral hospital: A prospective cohort study

Comparison of sequential versus pre mixed administration of intrathecal fentanyl with hyperbaric bupivacaine for patients undergoing elective Caesarean section at Zewditu memorial referral hospital: A prospective cohort study

A Comparison of Subarachnoid Block Characteristics Following Co-administration of Fentanyl Premixed With Hyperbaric Bupivacaine Versus Antecedent or Succedent to Hyperbaric Bupivacaine: A Randomized Controlled Study

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