Hemodynamic and analgesic effect of intrathecal fentanyl with bupivacaine in patients undergoing elective cesarean section; a prospective cohort study.

Autor: Ebrie AM; Lecturer Department of Anesthesiology, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia., Woldeyohanis M; Lecturer Department of Anesthesia, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia., Abafita BJ; Lecturer Department of Anesthesiology, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia., Ali SA; Lecturer Department of Anesthesiology, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia., Zemedkun A; Lecturer Department of Anesthesiology, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia., Yimer Y; Lecturer, Department of Anesthesiology, Wollo University, College of Health Sciences and Medicine, Dessie, Ethiopia., Ashebir Z; Lecturer Department of Anesthesia, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia., Mohammed S; Lecturer, Department of Anesthesiology, Wollo University, College of Health Sciences and Medicine, Dessie, Ethiopia.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2022 Jul 07; Vol. 17 (7), pp. e0268318. Date of Electronic Publication: 2022 Jul 07 (Print Publication: 2022).
DOI: 10.1371/journal.pone.0268318
Abstrakt: Background: Spinal anesthesia with bupivacaine has side effects such as hypotension, respiratory depression, vomiting, and shivering. The side effects are dose-dependent, therefore different approaches have been attempted to avoid spinal-induced complications including lowering the dose of local anesthetic and mixing it with additives like Neuraxial opioids.
Objective: To compare the Hemodynamic and analgesic effects of intrathecal fentanyl as an adjuvant with low and conventional doses of bupivacaine in patients undergoing elective cesarean section under spinal anesthesia.
Methodology: An institutional-based prospective cohort study was conducted on 90 patients. Data was collected with chart review, intraoperative observation, and postoperatively patient interview. Data was entered into EPI INFO and transport to SPSS version 23 for analysis of variables using one-way ANOVA, Kruskal Wallis H rank test, and chi-square.
Result: Hypotension but not bradycardia, was significantly frequent in a conventional dose of bupivacaine alone (CB) group and a conventional dose of bupivacaine with fentanyl (CBF) groups than that of the lower dose of bupivacaine with fentanyl (LBF) groups. Duration of analgesia was significantly longer in LBF (248± 35.6 minutes) and in CBF groups (260.3±40.3 minutes) than in CB group (167.10 ± 31.45 minutes). Time for the first analgesic request was significantly later in LBF (304±47.8 minutes) and CBF (294.6±99.5 minutes) groups than that in CB group (177±25.88 minutes).
Conclusion: The Lower dose of bupivacaine is associated with less risk of hypotension and faster recovery. Adding fentanyl with the lower dose of bupivacaine in spinal anesthesia for cesarean section could provide comparable anesthesia with the lower risk of hypotension and longer postoperative analgesia.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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