DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20151193

Comparative study of 0.5% hyperbaric bupivacaine with sufentanil (5µg) and 0.5% hyperbaric bupivacaine for spinal anesthesia

Abdul Hakkim, Rajaclimax Kirubahar, Vijay Kanna, Murugadoss Kanagasabai

Abstract


Background: In the present day practice of Anesthesiology, bupivacaine is the most commonly used drug for spinal anesthesia. To improve the quality of analgesia and prolong the duration of its action, many adjuvants have been tried. Intrathecal opioids have been found to fulfil both these objectives. This study was done to evaluate the effects of adding sufentanil to bupivacaine for spinal anesthesia.

Methods: 100 ASA grade I/II patients aged between 20 – 60 years undergoing elective lower abdominal, urologic, lower limb surgeries were selected and divided into two groups of 50 each. Group A received 2.5 ml of heavy Bupivacaine, whereas the second group B received 2.5 ml of heavy Bupivacaine with 5 µg Sufentanil. Parameters - Onset and duration of sensory block and motor block, time for two dermatomal segments regression, duration of analgesia, vitals and side effects were assessed.

Results: There was no variation in onset of sensory blockade and motor blockade. The time to achieve peak sensory level was 3 minutes earlier in group B. The time for two segment regression and the time to full sensory and motor recovery were prolonged in Group B. Duration of complete and effective analgesia prolonged by 40-60 minutes and the time for first request of analgesic postoperatively was delayed by 70 - 80 minutes in group B. The quality of analgesia was better in group B. Pruritus was the common side effect in group B.

Conclusions: Sufentanil potentiates bupivacaine spinal anesthesia by increasing the duration and improving the quality of analgesia with minimal side effects.

 


Keywords


Spinal anesthesia, Sufentanil, Bupivacaine, Visual analogue scale, Complete and effective analgesia

Full Text:

PDF

References


Brunton LL, Lazou JS, Parker LL. Goodman & Gilman’s. The Pharmacological Basis of Therapeutics.11th edn. Mc Graw Hill Medical Publications. 571,582.

Hashimoto K, Hampl K, Nakamura Y. Epinephrine Increases the Neurotoxic Potential of Intrathecally Administered Lidocaine in the Rat. Anesthesiology. 2001;94(5):876-81.

Karthivel S, Sadhasivam S, Saxena A, Kannan TR, Ganjoo P. Effects of intrathecal ketamine added to bupivacaine for spinal anaesthesia. Anaesthesia. 2001;55(9):899-904.

Buerkle H, Yang LC. The novel analgesic neostigmine and the morning after: Nothing more than sedation, nausea and vomiting? Acute Pain. 1999;2(1):41.

Biswas N, Rudra A, Bose BK, Nath S. Intrathecal fentanyl with hyperbaric bupivacaine improves analgesia during caesarian delivery and in early post-operative period. Indian J Anaesth. 2002;46(6):469-72.

Braga Ade F, Braga FS, Potério GM, Pereira RI, Reis E, Cremonesi E. Sufentanil added to hyperbaric Bupivacaine for subarachnoid block in caesarean section. European Journal of Anesthesiology. 2003:20:631-5.

Ngiam SKK, Chong JL. The addition of intrathecal sufentanil and fentanyl to bupivacaine for caesarean section. SMJ. 1998;39(7):290–4.

Dahlgren G, Hultstrand C, Jakobsson J, Norman M, Eriksson E, Martin H. Intrathecal Sufentanil, Fentanyl, or placebo added to Bupivacaine for Cesarean Section. Anesth Analg. 1997;85:1288-93.

Lin BC, Lin PC, Lai YY, Huang SJ, Yeh FC. The maternal and fetal effects of the addition of sufentanil to 0.5% bupivacaine for caesarean delivery. Acta Anaesthesiol Sin. 1998;36(3):143-8.

Courtney MA, Bader AM, Hartwell B, Hauch M, Grennan MJ, Datta S. Perioperative analgesia with subarachnoid sufentanil administration. Reg Anesth. 1992;17(5):274-8.

Olofsson C, Nygards EB, Bjersten AB, Hessling A. Low-dose bupivacaine with sufentanil prevents hypotension after spinal anesthesia for hip repair in elderly patients. Acta Anaesthesiol Scand. 2004;48(10):1240-4.