Comparative Study of Intrathecal Levobupivacaine-Fentanyl and Levobupivacaine in Caesarean Deliveries

Abstract

BACKGROUND The aim of the study is to compare the effects of intrathecal levobupivacaine-fentanyl and levobupivacaine on quality of intrathecal/subarachnoid block and haemodynamic variations in caesarean deliveries. MATERIALS AND METHODS The study was designed as a prospective randomised double-blind study enrolling a total of 60 female patients (age group-20-40 years) belonging to ASA grade I and II. The patients were randomly allocated into two groups of 30 patients in each group. The Group-LF received levobupivacaine 10 mg (2 mL) + fentanyl 20 mcg (0.4 mL) and Group-LN received levobupivacaine 10 mg (2 mL) + normal saline (0.4 mL). Characteristics of spinal block, Apgar score, vital parameter variations and complications were recorded. RESULTS In Group LF, onset of action was faster in relation to sensory and motor blockade as compared to Group LN. Two segment regression of sensory block and duration of motor block were prolonged with addition of fentanyl to levobupivacaine. Addition of fentanyl to intrathecal levobupivacaine, prolonged duration of sensory and motor block with faster onset of sensory and motor block with better quality as compared to levobupivacaine. Statistically, no significant difference was observed in mean Apgar score at 1 and 5 minutes. There was no much difference between the groups in relation to haemodynamic variations and complications. CONCLUSION Intrathecal levobupivacaine with fentanyl was found to improve the quality and prolonged duration of intrathecal block. It reduced the need for rescue analgesia/supplementary analgesics for postoperative pain relief without any significant side effects. The levobupivacaine with or without fentanyl maybe used safely for spinal anaesthesia in elective caesarean deliveries.