SPINAL-EPIDURAL ANALGESIA

EFFECTIVENESS OF DIFFERENT DOSES OF INTRATHECAL BUPIVACAINE COMBINED WITH FENTANYL FOR SPINAL-EPIDURAL ANALGESIA IN LABOR

  • Muhammad Saleh Khaskheli SICU and Pain Center, PMC Hospital, Nawabshah.
  • Rafia Tabassum SICU and Pain Center, PMC Hospital, Nawabshah.
  • Aijaz Hussan Awan SICU and Pain Center, PMC Hospital, Nawabshah.
Keywords: Analgesia, Bupivacaine, Fentanyl, Labor, Spinal-Epidural

Abstract

Objectives: To compare the efficacy of bupivacaine 2.5 mg and fentanyl 25 ìg
with bupivacaine 1.25 mg and fentanyl 25ìg for spinal-epidural analgesia in the first stage of
labor. Study Design: Double-blind randomized controlled trial. Setting: Anesthesia Department,
Surgical Intensive Care Unit, and Pain management clinic, Peoples Medical College Hospital
Nawabshah. Period: August 2014 to July 2015. Methodology: All the participants meeting the
eligibility criteria were randomly allocated into two groups i.e. intervention (I) and control (II),
with the allocation ratio of 1:1. Patients in the Group I (intervention) received intrathecal Inj.
Bupivacaine 1.25 mg (0.5% Bupivacaine 0.25ml) and Inj. Fentanyl 25 ìg whereas the Group
II (control) was given intrathecal Inj. Bupivacaine 2.5 mg (0.5% Bupivacaine 0.5ml) and Inj.
Fentanyl 25 ìg for combined spinal epidural analgesia, both made up of total volume of 2 ml of
normal saline. Mean±SD (standard deviation) was computed for continuous data (age, weight,
VAS). Frequency and percentages was calculated categorical data. Independent t test and Chi
square test were used for the differences between the groups. Results: The age of all the cases
was 27.64±4.07 years. Moreover, groups were homogenous at baseline (p<0.05) in terms of
mean age, weight, cervical dilatation, gravida, and ASA classification. Mean pain score on VAS
was not significant between groups at 0 min and 15 min however mean pain score was found
significantly low (p<0.05) in group-I. Likewise, efficacy of Bupivacaine 1.25 mg and Fentanyl 25
ìg (group-I) was significantly higher than the other group. Conclusion: Low-dose bupivacaine
1.25 mg was significantly more effective than high-dose (2.5 mg) bupivacaine when added to
25 ìg of fentanyl for combined spinal-epidural analgesia in the first stage of labor, having fewer
chances of sensory and motor block, and hypotension.

Author Biographies

Muhammad Saleh Khaskheli, SICU and Pain Center, PMC Hospital, Nawabshah.

FCPS (Anaesthesiology), MCPS
MSc (Pain Medicine)
Professor and Chairman
Department of Anaesthesiology

Rafia Tabassum, SICU and Pain Center, PMC Hospital, Nawabshah.

FCPS (Anaesthesiology),
Diploma in Anaesthesiology
(LUMHS)
Assistant Professor
Department of Anaesthesiology

Aijaz Hussan Awan, SICU and Pain Center, PMC Hospital, Nawabshah.

Diploma in Anaesthesiology
(LUMHS), MBBS
Specialist Anaesthetist
Professor & Chairman
Department of Anaesthesiology

Published
2018-10-10