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Randomized controlled study comparing the efficacy of neuraxial blockade by using intrathecal administration of 0.5% hyperbaric bupivacaine 15mg and fentanyl 25mcg - in a single syringe versus separate syringe techniques in inguinal hernia surgeries

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Original Article

Author Details : Takkillapati Raghavendrati Manoj Kumar, Ramamurthy Balaji*

Volume : 7, Issue : 3, Year : 2020

Article Page : 394-398

https://doi.org/10.18231/j.ijca.2020.072

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Abstract

Introduction: Adjuvants premixed with local anaesthetic solution can alter the density of the hyperbaric
solution affecting the spread of block. Administering local anaesthetic and adjuvant in a separate syringe
may minimize these changes with respect to densities. Hence we aimed to compare the efficacy of the drugs
when administered sequentially and as a mixture.
Objective: To compare the efficacy of neuraxial blockade with pre- mixed fentanyl and 0.5% hyperbaric
bupivacaine and sequential administration of fentanyl and 0.5% hyperbaric bupivacaine.
Materials and Methods: After obtaining the institutional ethics committee approval, patients were
randomly allocated into Group M = received spinal anesthesia using 15mg of 0.5% bupivacaine heavy and
25mcg fentanyl premixed in the same syringe. Group S = received spinal anesthesia sequentially. Drugs
were injected through 25 gauge quincke’s needle in sitting position, inserted at L3-L4 space. Onset of block
,hemodynamics, duration of analgesia and complications were monitored.
Results: Group S had slower onset and slow progression of the block with more time taken to regression
of the block compared to the group Incidence of hypotension ,bradycardia was less in group S compared to
group M.
Conclusion: We conclude that administrating adjuvants to local anaesthesia sequentially is better than
mixing them in a single syringe in terms of surgical anaesthesia, hemodynamic stability and post operative
pain relief.

Keywords: Adjuvants premixed, Bupivacaine, Fentanyl, Sequential administration.

How to cite : Kumar T R M, Balaji R , Randomized controlled study comparing the efficacy of neuraxial blockade by using intrathecal administration of 0.5% hyperbaric bupivacaine 15mg and fentanyl 25mcg - in a single syringe versus separate syringe techniques in inguinal hernia surgeries. Indian J Clin Anaesth 2020;7(3):394-398

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