Spinal anaesthesia using isobaric levobupivacaine alone and with fentanyl for lower abdominal surgery--a randomised double blinded controlled trial

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Publisher: Akshantala Enterprises Private Limited
Document Type: Report
Length: 3,956 words
Lexile Measure: 1630L

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Abstract :

BACKGROUND Levobupivacaine has equal potency as bupivacaine but lower CVS and CNS toxicity. Aim was to evaluate clinical efficacy of isobaric levobupivacaine with or without fentanyl in spinal anaesthesia for inguinal hernia surgeries regarding sensory-motor block characteristics, haemodynamic profile and complications. MATERIALS AND METHODS After approval from institutional ethical committee (IEC) and informed written consent, a randomised double blinded controlled trial was conducted during 1 year period. 60 patients of ASA I-II of age 20-60 years, weight 40-90 kg, were divided into two groups 30 each, to receive either 4 mL of 0.5% isobaric levobupivacaine (group L) or 4 mL of 0.5% isobaric levobupivacaine + 25 [micro]g fentanyl (group LF) intrathecally. Exclusion criteria- uncooperative patient and patient refusal, h/o allergy to study drugs, vertebral deformity, morbid obesity and any other associated systemic illness. Patients were monitored for sensory and motor block characteristics, postoperative analgesia, haemodynamics, side effects and complications. Data analysed by using Student t test and Chi square test; p RESULTS Onset of sensory block and time to reach peak sensory level was shorter in group LF (6.40 [+ or -] 0.67 and 7.17 [+ or -] 0.79 min.) as compared to group L (8.20 [+ or -] 0.76 and 9.27 [+ or -] 0.98 min.) (p=0.00). Onset of motor block was shorter in group LF (8.57 [+ or -] 1.04 min.) compared to group L (9.10 [+ or -] 0.92 min.). Duration of analgesia was prolonged in Group LF (152 [+ or -] 3.89 min.) compared to Group L (142.30 [+ or -] 18.4 min.), (p=0.007). Haemodynamic variables and demographic data were comparable in both groups. CONCLUSION Isobaric levobupivacaine in spinal anaesthesia produces effective sensory-motor block of sufficient duration with stable haemodynamic profile in lower abdominal surgeries. Addition of fentanyl to levobupivacaine results in shortening of onset time, increased peak sensory level and prolonged duration of analgesia. KEYWORDS Levobupivacaine, Fentanyl, Inguinal Hernia Surgeries, Spinal Anaesthesia.

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Gale Document Number: GALE|A497053237