EFFICACY OF LOW DOSE HEAVY BUPIVACAINE WITH FENTANYL IN SPINAL ANESTHESIA FOR CAESAREAN DELIVERY

Abstract

Spinal anesthesia is a preferred anesthetic technique for elective caesarean deliveries, for which hypotension remains a significant side effect. We designed the present randomized trial to test the hypothesis that reducing the spinal dose of local anesthetics results in equally effective anesthesia and less maternal hypotension. One hundred patients with American Society of Anesthesiologists physical status (ASA) I–II, age 19 to 38 years, were randomized
into two groups. The studied cases were admitted in Al-salam hospital, Misurata and Misurata central hospital.
Patients in group A (n=50) were given spinal anesthesia using 10 mg heavy Bupivacaine with 25 µg fentanyl. Patients in group B (n=50) were given spinal anesthesia using 7.5 mg heavy Bupivacaine with 25 µg fentanyl. Vital
signs were monitored, the time it took to reach the T3 dermatomal level, duration of cesarean delivery, duration of
adequate anesthesia. The Apgar score of the newborn were compared between the two groups. Duration of adequate
anesthesia was longer in A group, more patients in the group experienced hypotension. However, Neonatal outcomes were similar in both groups. We conclude that small-dose spinal anesthesia (group B) better in preserving
maternal hemodynamic stability with equally effective anesthesia that for shorter duration, it may be feasible only
when the block can be reinforced using a functional epidural catheter.