Online ISSN: 2515-8260

Keywords : Caesarean

Comparative study of low dose subarachnoid bupivacaine (9 mg) with different dose combinations of fentanyl versus standard dose bupivacaine (12 mg) in parturients undergoing caesarean section

Ashok Rout, Sunny Eapen, Dewendra J Gajbhiye, P Ansuman Abhisek, Pradeep Kedar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1499-1506

Background: Opioids and local anaesthetics act synergistically and it’s a popular technique to combine bupivacaine and fentanyl in spinal anaesthesia for caesarean delivery. The aim of the study was to find out optimal dose combination of bupivacaine and fentanyl for spinal anaesthesia for better quality of perioperative analgesia and reduction of feto-maternal adverse outcome during caesarean section.
Methods: Three hundred and four parturients scheduled for caesarean delivery were randomly allocated to four groups of 76 each. Data of 298 parturients (Gp I=73, Gp II=75, Gp III=75 and GP IV=75) was included in the primary outcome analysis. The control group received 12 mg of 0.5% hyperbaric bupivacaine for spinal anaesthesia. Fentanyl 15, 20 or 25 μg was added to each study group who received 9 mg of 0.5% hyperbaric bupivacaine in spinal anaesthesia. Onset and duration of spinal anaesthesia, hemodynamic parameters, intraoperative nausea & vomiting (IONV), failed block, APGAR score and other side effects were noted.
Results: The duration of effective and complete analgesia was significantly longer in all fentanyl groups. However, increasing the dose of fentanyl from 15 to 25 μg had little effect on further prolongation of analgesia. Duration of motor blockade was significantly prolonged in control group. The incidence of hypotension and IONV episodes were significantly low in the study groups.
Conclusion: Bupivacaine and fentanyl have super additive effect in spinal block. However, strict drug dose calculation is required in spinal anaesthesia to minimize adverse outcomes during caesarean delivery. Spinal anaesthesia with fentanyl 15 μg and 0.5% hyperbaric bupivacaine, 9 mg provides optimal surgical conditions for caesarean delivery with negligible side effects as compared to other dose combinations.

Rising Trend Of Caesarean Section: Review On The Determinants Of Cesarean Section Deliveries

Dr. Rajeesh C Sarngadharan; KR Vandana; KT Nandu

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 7, Pages 5904-5909

Ensuring safe pregnancy and child birth is an important component of Reproductive and Child Health initiatives, in this scenario, there has been a concern over the rising cesarean rates over the world. Cesarean section is the surgical intervention in child birth in case of serious delivery complications for saving the life of mother and child. Over the last decades, consistent increase is observed in the rate of cesarean section deliveries in most of the developed countries and in many developing countries including India. The determinants contributing high CS rates are multifactorial and not well understood.