Online ISSN: 2515-8260

Keywords : hyperbaric bupivacaine

Efficacy of 0.8 mg Nalbuphine and 20mcg Fentanyl as adjuvants in Subarachnoid Block for lower limb orthopaedic surgery: A Randomized Controlled Trial

Jayesh Jagannath Bawa; Shubhada Rajendra Deshmukh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 1882-1891

Background: In lower limb orthopedic surgeries there is significant postoperative pain, which is difficult to treat with oral or intravenous analgesics resulting in adverse endocrine, metabolic and inflammatory responses. Morphine, Pethidine, Fentanyl, and other opioids fall under the Narcotics Act whereas nalbuphine does not. So, the accessibility of Nalbuphine is not as major a concern in several hospitals in India as that of morphine and other such opioids. Present study was aimed to compare the effectiveness of 0.8mg nalbuphine with 20 mcg fentanyl as an adjuvant to hyperbaric bupivacaine in lower limb orthopedic surgeries. Material and Methods: Present study was single-center, prospective, comparative study, conducted in patients of either gender, age group of 18-60 years, belonging to ASA CLASS 1 and 2, With BMI < 30, undergoing elective orthopedic lower limb surgery. Patients were allocated in Group N- Received intrathecal 0.8 mg Nalbuphine & 3 ml 0.5 % H bupivacaine & Group F- Received intrathecal 20 mcg Fentanyl & 3 ml 0.5 % H bupivacaine.

Comparative study of 0.5% bupivacaine (Heavy) and 0.5% bupivacaine (Heavy) with dexmedetomidine for subarachnoid block in lower limb an

Dr. N Gopal Reddy, Dr. R Gnana Sekar, Dr. Y Pooja Reddy, Dr. V Jyothi, Dr. Ch Mallika, Dr. V Vinuthna

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2179-2186

Spinal anaesthesia remains one of the basic techniques despite the waxing and waning of its popularity over last 100 years since its introduction various agents have been used with local anaesthetics in spinal anaesthesia to improve the quality of block and to provide prolonged postoperative analgesia.
AIM: In the present study, we tried to study effectiveness of intrathecal 0.5% bupivacaine (heavy) alone and with Dexmedetomidine as an adjuvant for lower limb and lower abdominal surgeries.
Material and Methods: The study was conducted in the department of anaesthesiology, KIMS, Narketpally during Oct 2021 to Sep2022.This study was a prospective, randomised controlled, single blind, study conducted in 60 patients of ASA grade I and II undergoing elective surgeries. The patients were divided by random number table into two groups, containing 30 patients in each group. Dosages of drugs selected are divided as Group B: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) and Group BD: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) plus 5 µg Dexmedetomidine. Spinal block characteristics, haemodynamics and side effects were observed.
Results: It was found that in Dexmedetomidine group time to reach T10 sensory blockade and complete motor blockade and was earlier and a higher and prolonged when compared to the control group. Haemodynamic parameters were preserved both intra-operatively and postoperatively. There were a small percentage of patients who had minor side effects.
Conclusion: Intrathecal low dose Dexmedetomidine in a dose of 5µg along with 0.5% hyperbaric bupivacaine given intrathecally prolongs significantly the duration of sensory and motor blockade

To Evaluate Efficacy and Safety of Isobaric Levobupivacaine Versus Hyperbaric Bupivacaine in Lower Limb Orthopaedic Surgeries

Anjani Kumar Singh, Selvakumar Palaniappan, K. Selvaraju

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 310-316

Background: Neuraxial anaesthesia greatly expand the anaesthesiologist
armamentarium in many cases providing alternative to general anaesthesia. Spinal
anaesthesia is a popular technique for lower limb orthopaedic surgeries. Hyperbaric
bupivacaine in 8% glucose is often used. Unintended intravascular injection of
bupivacaine during regional anaesthesia may cause severe cardiovascular toxicity,
including left ventricular depression,atrioventricular heart block,life threatnig
ventricular tachycardia, fibrillation and sudden cardiac arrest which is difficult to
resuscitate However levobupivacaine has similar efficacy but better safety profile than
racemic bupivacaine.


Dr Thatipamula Nagapraveen, Dr Vuppu Bhavani, Dr Neela Sandeep Kumar, Dr Pakala Swathi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5952-5961

Introduction:Postoperative analgesia after cesarean section poses unique clinical challenges
to anesthesiologist. Intrathecal buprenorphine is a promising drug for postoperative analgesia.
Aims: The aim of this study was to compare the efficacy of two doses of buprenorphine (45
μg and 60 μg) as an adjuvant to hyperbaric bupivacaine for postoperative analgesia in
caesarean section.
Materials and methods: This was a prospective, randomized, double-blind controlled study.
Ninety ASA physical status Class II parturients posted for elective caesarean section. The
computer-generated simple random sampling procedure was used to allocate the subjects into
three Groups A, B, C of 30 each.
Results: Addition of buprenorphine to intrathecal bupivacaine prolonged the duration and
quality of postoperative analgesia without producing any major side effect. The maximum
duration of analgesia and hence decreased analgesic requirement were obtained with 60 μg
buprenorphine. Addition of buprenorphine did not have any adverse outcome on the baby as
assessed by Apgar score.
Conclusion:Addition of buprenorphine to hyperbaric bupivacaine provides postoperative
analgesia after cesarean section without significant maternal and neonatal side effects.

Comparison of Hyperbaric Bupivacaine Alone and Combination of Hyperbaric Bupivacaine with Clonidine in Cesarean Section: A Prospective Randomized Clinical Trial

Aman Malawat, Sudhir Sachdev, Sakshi Kanoji, Mangilal Deganwa, Durga Jethava

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10480-10489

Introduction: Spinal anaesthesia using hyperbaric bupivacaine with adjuvants such as
clonidine is now the routine and preferred technique for majority of the surgical cases.
Aim: to compare various block characteristics alongwith materno-fetal outcome in
patients scheduled for caesarean section under subarachnoid block (SAB), following
administration of hyperbaric bupivacaine alone and in combination with clonidine
Methods: In this randomized clinical trial, 90 patients undergoing elective cesarean
section were randomly allocated to two groups. The patients of Group A received
intrathecal 0.5% hyperbaric Bupivacaine (10 mg) + 0.2 mL of normal saline and Group
B received intrathecal 0.5% hyperbaric Bupivacaine (10 mg) + 0.2 mL of clonidine (30
μg). Various block characteristics and materno-fetal outcome were compared between
the groups.
Results: Group B had quicker sensory onset (3.17 ± 1.05 min vs. 3.50 ± 0.94 min), longer
duration of sensory and motor block (209.73 ± 30.70 min and 147.50 ± 23.00 min),
longer time for rescue analgesia demand (298.83 ± 44.68 min) in comparison to Group
Conclusion: Intrathecal clonidine provided better block characteristics and outcome
measures in terms of prolonged sensory as well as motor blockade, longer duration of
analgesia, greater intraoperative relaxation and minimal or no adverse incidences.