Abstract

Background: Subarachnoid block is commonest anaesthetic technique used for most gynaecological surgeries. Local anaesthetic agents have traditionally been used for this, but with the discovery of opioid receptors in spinal cord in substantia gelatinosa. Possibility of synergism between opioids & local anaesthetics co-administered intrathecally has been explored for various lower abdominal surgeries.

Aims & Objective: To study was to compare effect of intrathecal bupivacaine with bupivacaine, fentanyl mixture to assess safety and efficacy, peri –operative hemodynamic stability postoperative pain relief in major gynecological surgeries.

Materials and Methods: 60 female patients with American society of anaesthesiologists (ASA) grade I OR II were divided in two groups after matching. Group BF received inj. Bupivacaine 15 mg (0.5%) 3 ml + inj. Fentanyl 25 mcg, (50 mcg/ml), 0.5 ml and Group B: (inj. Bupivacaine 15 mg (0.5%) 3 ml + Normal Saline (0.5 ml), total volume was 3.5 ml in each group. Spinal anaesthesia was given with conventional technique.

Results: Duration of sensory block and effective analgesia was prolonged while there was no change in duration of motor block with intrathecally bupivacaine with fentanyl as compared to inj. Bupivacaine alone.

Conclusion: Intrathecal Fentanyl as an adjuvant to bupivacaine improves quality of block with longer duration of sensory block & prolongs duration of effective analgesia.

Key words: Bupivacaine; Fentanyl; American Society of Anaesthesiologists (ASA); Anaesthesia