Singariya Geeta, Choudhary Kusum, Kamal Manoj, Bihani Pooja, Pahuja Himani, Saini Pradeep
Department of Anaesthesiology and Critical Care, Dr S N Medical College, Jodhpur, Rajasthan, India.
Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Indian J Anaesth. 2021 Feb;65(2):102-107. doi: 10.4103/ija.IJA_816_20. Epub 2021 Feb 10.
Preservative free 1% 2-chlorprocaine is a short acting local anaesthetic agent suitable for day care surgical procedures. Potentiation of analgesic action of intrathecal local anaesthetics by the addition of opioids is well known. In this study, we investigated the effect of intrathecal fentanyl as an adjuvant to 1% 2-chloroprocaine (2-CP) in parturients undergoing elective lower segment caesarean section (LSCS).
This prospective randomised comparative study was performed on 150 healthy, term parturients planned for elective low risk LSCS, divided into two equal groups. The group CS received 1% preservative-free 2-CP 3 ml (30 mg) + 0.5 ml normal saline and group CF received 1% preservative-free 2-CP 3 ml (30 mg) + 0.5 ml fentanyl (25 μg) with a total volume of 3.5 ml intrathecally in both groups. The duration of sensory blockade, duration of motor blockade, maximum height of sensory block, haemodynamic parameters, quality of block, neonatal outcome, patient satisfaction and any side effects were recorded.
There were no significant differences in demographic characteristics, haemodynamic parameters, onset of sensory block, onset of motor block and duration of motor block between the groups. The duration of sensory block and duration of analgesia was statistically prolonged in group CF than group CS ( value < 0.0001). There was no statistical difference in the Apgar score of newborns in both groups. The adverse effects (hypotension, bradycardia, nausea/vomiting, shivering and transient neurological symptoms) were comparable in both the groups.
The addition of fentanyl to 1% 2-chloroprocaine intrathecally prolonged the duration of sensory block and postoperative analgesia in patients undergoing LSCS.
不含防腐剂的1%氯普鲁卡因是一种短效局部麻醉剂，适用于日间手术。鞘内注射局部麻醉剂时添加阿片类药物可增强镇痛作用，这是众所周知的。在本研究中，我们调查了鞘内注射芬太尼作为1%氯普鲁卡因（2-CP）辅助剂在择期下段剖宫产（LSCS）产妇中的效果。
本前瞻性随机对照研究对150例计划行择期低风险LSCS的健康足月产妇进行，分为两组，每组75例。CS组接受1%不含防腐剂的2-CP 3 ml（30 mg）+0.5 ml生理盐水，CF组接受1%不含防腐剂的2-CP 3 ml（30 mg）+0.5 ml芬太尼（25μg），两组鞘内注射总量均为3.5 ml。记录感觉阻滞持续时间、运动阻滞持续时间、感觉阻滞最高平面、血流动力学参数、阻滞质量、新生儿结局、患者满意度及任何副作用。
两组在人口统计学特征、血流动力学参数、感觉阻滞起效时间、运动阻滞起效时间和运动阻滞持续时间方面无显著差异。CF组感觉阻滞持续时间和镇痛持续时间在统计学上比CS组延长（值<0.0001）。两组新生儿阿氏评分无统计学差异。两组不良反应（低血压、心动过缓、恶心/呕吐、寒战和短暂性神经症状）相当。
鞘内注射1%氯普鲁卡因时添加芬太尼可延长LSCS患者的感觉阻滞持续时间和术后镇痛时间。
