COMPARISON OF FRACTIONATED DOSE VERSUS BOLUS DOSE INJECTION OF HEAVY BUPIVACAINE WITH FENTANYL IN SPINAL ANAESTHESIA FOR PATIENTS UNDERGOING ELECTIVE CAESAREAN SECTION: ONE YEAR RANDOMIZED CLINICAL TRIAL
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 3324-3330
AbstractBackground and Aim: Maternal hypotension is the common complication encountered after subarachnoid block (SAB).
This needs attention and treatment for the better maternal and foetal outcome. Administration of SAB with bolus dose of local anaesthetic produce faster onset and precipitate maternal hypotension. Injecting fractionated dose provides dense block and haemodynamic stability. Aim of this study was to compare fractionated and bolus dose of SAB in terms of haemodynamic stability and duration of analgesia.
Methodology: Eighty parturients undergoing caesarean delivery under SAB were included in the study. They were divided into Group B or F according to computer randomization. Group B parturients received bolus dose SAB with 2ml of 0.5% hyperbaric bupivacaine and 10µg of fentanyl. Group F parturients received fractionated dose of 2ml of 0.5% hyperbaric bupivacaine and 10µg of fentanyl. In which, from the total dose two-third was given initially. After 90 sec remaining one third of the dose was injected. Haemodynamic parameters and analgesia period were analyzed using Student’s unpaired t‑test.
Results: The haemodynamic parameters were better in group F than group B. The number of patients required vasopressor in group F were six and group B were seventeen. There was a prolonged analgesia period in group F than group B (214.40 + 15.48 and 195.95 + 8.98 min respectively).
Conclusion: The patients in fractionated dose group were haemodynamically better with longer analgesia period than bolus dose group. It is a newer technique to prevent maternal hypotension after SAB.
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