Shakil Malik, Rajeve Kumar Chawla, Sagar Khurana, Shaheera Shakil, Rahma Rashid.
Comparative study of intrathecal low dose bupivacaine fentanyl versus conventional dose of bupivacaine in parturients undergoing cesarean section.
Pak J Surg Jan ;37(1):32-6.

Objectives: To compare effectiveness of low-dose bupivacaine-fentanyl versus conventional dose of bupivacaine in parturients undergoing cesarean section and the frequency of hypotension in two regimens. Study design: Randomized clinical study Place and duration of study: Anesthesiology Department and Surgical Intensive Care Unit and Pain Management, Civil Hospital, Dow University of Health Sciences, from July to December 2019. Material and methods: 52-women undergoing cesarean section were randomly allocated into two groups; 26-patients in group-A were given 10 mg bupivacaine, and 26 in group-B, 5 mg bupivacaine-25ug fentanyl. Blood pressure (BP) and heart rate were recorded. Intra-operative pain assessment was done using visual analog scale (VAS). Duration of effective analgesia was taken from the time of intra-thecal injection to a VAS score >=4. Systolic BP (SBP)<20% of preoperative value was labelled as hypotension. Data was analyzed with SPSS 19. Results: Mean age was 26.19+-4.31 years. There was no significant difference among age, weight, height and ASA of patients in two groups (p=0.65, 0.052, 0.19, and 0.39, respectively). Mean baseline SBP, diastolic blood pressure (DBP), and heart rate were not significantly different. Mean final SBP was significantly different (p = 0.006), while no significant difference was seen in DBP and heart rate and duration of surgery (p=0.23, 0.42, 0.23, respectively). Th e duration of analgesia was more prolonged in group-B (p<0.001), and hypotension was significantly higher in group-A (p=0.005). Conclusion: Low-dose intra-thecal bupivacaine and fentanyl provides more effective spinal anesthesia for cesarean section with less hypotensive episodes.

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