Volume : 6, Issue : 7, July - 2017

COMPARISON OF INTRATHECAL BUPIVACAINE VERSUS BUPIVACAINE & FENTANYL IN LOWER LIMB ORTHOPAEDIC SURGERY FOR HAEMODYNAMIC STABILITY AND POSTOPERATIVE ANALGESIA.

Dr Sumit Bhargava, Dr Sudip Bhargava

Abstract :

<p>&nbsp;<b style="text-align: justify;"><span lang="EN-IN" style="font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;">Introduction</span></b><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;">: Trial of comparison of intrathecal bupivacaine versus bupivacaine &amp; fentanyl in lower limborthopaedic surgery for haemodynamic stability and postoperative analgesia.</span></p> <p class="MsoNormal" style="margin-top:12.0pt;margin-right:0in;margin-bottom:&#10;12.0pt;margin-left:0in;text-align:justify"><b><span lang="EN-IN" style="font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;">Material &amp; methods:</span></b><span lang="EN-IN" style="font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;"> Study was conducted in 60 ASA grade I &amp; II patient which were randomized into Group I received 3.0ml Bupivacaine intrathecally and 0.5ml normal saline. Group II Patients received 3.0ml bupivacaine + fentanyl 0.5 ml) intrathecally. &nbsp;Continuous monitoring of HR, BP, RR, SPO₂ was done during intraoperative &amp; post-operative period upto first requirement of analgesic.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:12.0pt;margin-right:0in;margin-bottom:&#10;12.0pt;margin-left:0in;text-align:justify"><b><span lang="EN-IN" style="font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;">Results</span></b><span lang="EN-IN" style="font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;"> :Duration, of analgesia with Bupivacaine alone was in the range of 150-280 minutes. Duration of analgesia was prolonged by addition of fentanyl. Duration of analgesia in group II was in the range of 440-660 minutes. In majority of patients in group 1 it was in the range of 121-240 minutes (n=21, 70%) while in group II, it was in the range of 481-600 minutes in majority of patients (n=18, 60.00%). The difference in mean duration of analgesia among both the groups (I &amp; II) was statistically significant (p&lt;0.0001) indicating that addition of fentanyl prolongs the duration of analgesia.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:12.0pt;margin-right:0in;margin-bottom:&#10;12.0pt;margin-left:0in;text-align:justify"><b><span lang="EN-IN" style="font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;">Conclusion:</span></b><span lang="EN-IN" style="font-size: 12pt; line-height: 115%; font-family: &quot;Times New Roman&quot;, serif;"> Intrathecal fentanyl with bupivacaine produces excellent surgical analgesia and extended analgesia in postoperative period.Increases intensity and duration of motor blockade Method of pre emptive analgesia avoids the multiple pricks for analgesia in the immediate postoperative period.Patients were sedated and comfortable throughout surgical procedure.&nbsp;<o:p></o:p></span></p>