Abstract

A PROSPECTIVE COMPARATIVE STUDY OF COMBINED SPINAL EPIDURAL LABOUR ANALGESIA WITH INTRATHECAL FENTANYL 25 MCG ALONG WITH TWO DOSES OF EPIDURAL BUPIVACAINE WITH EPIDURAL FENTANYL 2 MCG/ML

Author(s): K. Janaki Babu1

BACKGROUND
Combined Spinal Epidural Anaesthesia (CSEA) is frequently used for its rapid onset of analgesia and good patient satisfaction. In this group, various types of intrathecal intervention are possible.
The aim of the present study has been designed to evaluate the quality of analgesia when intrathecal fentanyl 25 mcg was given along with epidural 0.0625% bupivacaine 10 cc with fentanyl 2 mcg/mL in one group in companion with another group who has been given intrathecal fentanyl 25 mcg given long with epidural 10 cc bupivacaine 0.1% with fentanyl 2 mcg/mL.
MATERIALS AND METHODS
The parturients who fulfilling selection criteria were randomised and divided into two groups, group A and group B each having 30 patients. Group A were given intrathecal fentanyl 25 mcg with epidural 0.0625 mg bupivacaine 10 mL plus fentanyl 2 mcg/mL. Group B here received intrathecal fentanyl 25 mcg with epidural 0.1% bupivacaine 10 mL plus 2 mcg/mL fentanyl.
A long with routine preparation of normal delivery, parturient baseline HR, RR and BP was recorded.
RESULTS
Parameters total dose of bupivacaine required in group A was 30.46 mg, and in group B, it was 20.62 mg, which was not significant statistically. Total dose of fentanyl was 60.86 mcg in group A and 59.42 mcg in group B, which not significant. Mean of total number of top-up required in group A and group B was 4.02 and 3.96, respectively. Total volume of epidural drugs required was 30.9 mL in group A and 29.46 mL in group B. Height of dermatome reached up to T8 in 18 patients in group A; in 6 patients, it reached up to T9; and in 6 patients, it reached up to T10. Similarly, height of dermatome reached in group B up to T8 in 16 patients, up to T9 in 7 patients and up to T10 in 6 patients.
CONCLUSION
We would like to conclude that both dose of bupivacaine is associated with quality of labour analgesia, but dose requirement for 0.1% bupivacaine was less. Both are associated with no motor blocked and duration of labour was decreased and also not associated with any vital parameter abnormality.