Lecturer Department of Anesthesiology, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.
Lecturer Department of Anesthesia, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
PLoS One. 2022 Jul 7;17(7):e0268318. doi: 10.1371/journal.pone.0268318. eCollection 2022.
Spinal anesthesia with bupivacaine has side effects such as hypotension, respiratory depression, vomiting, and shivering. The side effects are dose-dependent, therefore different approaches have been attempted to avoid spinal-induced complications including lowering the dose of local anesthetic and mixing it with additives like Neuraxial opioids.
To compare the Hemodynamic and analgesic effects of intrathecal fentanyl as an adjuvant with low and conventional doses of bupivacaine in patients undergoing elective cesarean section under spinal anesthesia.
An institutional-based prospective cohort study was conducted on 90 patients. Data was collected with chart review, intraoperative observation, and postoperatively patient interview. Data was entered into EPI INFO and transport to SPSS version 23 for analysis of variables using one-way ANOVA, Kruskal Wallis H rank test, and chi-square.
Hypotension but not bradycardia, was significantly frequent in a conventional dose of bupivacaine alone (CB) group and a conventional dose of bupivacaine with fentanyl (CBF) groups than that of the lower dose of bupivacaine with fentanyl (LBF) groups. Duration of analgesia was significantly longer in LBF (248± 35.6 minutes) and in CBF groups (260.3±40.3 minutes) than in CB group (167.10 ± 31.45 minutes). Time for the first analgesic request was significantly later in LBF (304±47.8 minutes) and CBF (294.6±99.5 minutes) groups than that in CB group (177±25.88 minutes).
The Lower dose of bupivacaine is associated with less risk of hypotension and faster recovery. Adding fentanyl with the lower dose of bupivacaine in spinal anesthesia for cesarean section could provide comparable anesthesia with the lower risk of hypotension and longer postoperative analgesia.
布比卡因椎管内麻醉具有低血压、呼吸抑制、呕吐和寒战等副作用。这些副作用与剂量有关，因此，人们尝试了不同的方法来避免脊髓麻醉引起的并发症，包括降低局部麻醉剂的剂量并将其与神经轴阿片类药物等添加剂混合。
比较鞘内芬太尼作为辅助剂与低剂量和常规剂量布比卡因在接受脊髓麻醉下择期剖宫产术患者中的血流动力学和镇痛效果。
对 90 例患者进行了基于机构的前瞻性队列研究。通过病历回顾、术中观察和术后患者访谈收集数据。将数据输入 EPI INFO 并传输到 SPSS 版本 23，使用单向方差分析、克鲁斯卡尔-沃利斯 H 秩检验和卡方检验对变量进行分析。
与低剂量布比卡因加芬太尼（LBF）组和常规剂量布比卡因加芬太尼（CBF）组相比，单纯常规剂量布比卡因（CB）组低血压的发生率显著较高，但心动过缓的发生率没有差异。LBF 组（248 ± 35.6 分钟）和 CBF 组（260.3 ± 40.3 分钟）的镇痛持续时间明显长于 CB 组（167.10 ± 31.45 分钟）。LBF 组（304 ± 47.8 分钟）和 CBF 组（294.6 ± 99.5 分钟）首次需要镇痛的时间明显晚于 CB 组（177 ± 25.88 分钟）。
低剂量布比卡因与低血压风险降低和更快的恢复相关。在剖宫产脊髓麻醉中，将芬太尼与低剂量布比卡因联合使用，可以提供类似的麻醉效果，同时降低低血压风险和延长术后镇痛时间。
