Ramalinga Raju A.V.S1, Y. Chakrawarthi2
Various local anaesthetic agents are used with good pharmacokinetic profile. Bupivacaine is a potent amide local anaesthetic producing prolonged anaesthesia along with that it produces more sensory than motor block. Only limitation with the use of bupivacaine is its cardio toxicity in high dose, it has been found that a mixture of local anaesthetic and opioids has supra additive effects in the spinal cord posterior horn pain transmission. The requirement of local anaesthetic will be submaximal, which improves and maintains the overall analgesic effect over the time, and with fewer side effects.
MATERIALS AND METHODS
It is a prospective study conducted in the department of anaesthesia and critical care at Konaseema institute of medical science, Amalapuram, Andhra Pradesh. This study was conducted between 2012-2013 and during this period 140 patients were included in to this study as per the exclusion and inclusion criteria.
Regarding onset of sensory block time to reach T10 level was 4.22 and 4.2 min respectively in group BF and group BT, which is statistically significant with P value <0.05. Peak sensory level achieved in group BF was T4 but in group BT it was T5. Time required to reach peak sensory level was 10.6 min in group BF and 10.8 in group BT which is statistically significant. Onset of motor block in group BF was 3.6 min and in group BT it was 4.2 mins. Total duration of motor block was more in BF group that is 280.4 min than group BT that is 260.4 min. Mean duration of 1st dose of rescue analgesia was 432.66 min in group BF and 400.20 min in group BT.
In our study we have found that there is no difference between the mean change in blood pressure, heart rate and respiratory rate, between two groups, which is supported by the study of various authors. Time to reach peak T10 level was 4.22 min and 4.39 min in group BF and BT respectively which is similar to the work of other authors and peak sensory level achieved by BF was higher than BT that is T4. Mean duration of sensory block was little higher in Group BT than the group BF which is similar to the work of Ravishankar et al., A. M. kaki et al.
Fentanyl, Tramadol, Bupivacaine, Spinal Anaesthesia.