Intrathecal isobaric ropivacaine-fentanyl versus intrathecal isobaric bupivacaine-fentanyl for labor analgesia: A controlled comparative double-blinded study

Potdar, Meenoti Pramod; Kamat, Laxmi; Jha, Tanya

doi:10.4103/2249-4472.132814

Cited by 2 publications

(5 citation statements)

References 2 publications

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“…In a similar study by Potdar MP et al, the incidence of assisted vaginal deliveries was similar in both bupivacaine-fentanyl, ropivacaine-fentanyl group with one forceps delivery in each group similar to our study. [11] Similar results were seen in other studies by Lee et al and Hughes et al [9,10] Incidence of foetal bradycardia was similar in both groups. This finding is in concurrence with the finding of several studies reporting incidence of FHR changes CSE.…”

Section: Vassupporting

confidence: 90%

“…with a P = 0.001. [11] The duration of analgesia was higher in this group because of use of a higher dose of fentanyl use of a higher dose of fentanyl when compared to our study. Hughes et al reported the mean height of sensory blockade to be T6 for ropivacaine 2.5 mg with 25 µg fentanyl, T5 for bupivacaine 2.5 mg with 25 µg fentanyl.…”

Section: Vascontrasting

confidence: 54%

“…Meenoti Pramod, Laxmi L Tanya et al reported that intrathecal ropivacaine 2.5 mg with 25 µg of fentanyl had onset of analgesia of 1.08±0.27 minutes compared to intrathecal bupivacaine 2.5 mg with 25 µg fentanyl of 1.1±0.3 seconds. [11] In this study, ropivacaine was found to have a statistically significant faster onset of analgesia, but it was clinically negligible. This was similar to the finding in our study groups with the onset of analgesia occurring within 5 minutes.…”

Section: Tablementioning

confidence: 56%

“…Potdar MP et al reported the mean height of sensory blockade to be T9 for ropivacaine 2.5 mg with fentanyl 25 µg versus T10 for bupivacaine 2.5 mg with 25 µg fentanyl. [11] Similarly, Lee et al observed the mean dermatome level to be T11 with bupivacaine 1.25 mg with fentanyl. [9] This difference in height of sensory block maybe because the above studies had put the patient in slightly head up position after spinal component to avoid higher level of block and hence not comparable to findings our study.…”

Section: Vasmentioning

confidence: 94%

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Combined Spinal Epidural Analgesia in Labour: Comparison of Bupivacaine 1.25 Mg With Fentanyl and Ropivacaine 2.5 Mg With Fentanyl Intrathecal

N¹,

Ravi²

2016

jebmh

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BACKGROUNDThe concept of CSE has come into existence with the aims to provide the benefits of spinal block along with flexibility of an epidural catheter so as to modify and prolong the block for a longer period. CSE can be used to reduce or eliminate the disadvantages of spinal and epidural anaesthesia while preserving their advantages. The CSE technique has been used for orthopaedic and trauma surgery of lower limb, general surgery, urologic surgery, gynaecologic surgery, caesarean section, management of labour pain and postoperative pain. CSE blocks have also been used as research tools for controlled comparison between different epidural and subarachnoid techniques. Furthermore, the technique has been used successfully in all age groups including preterm neonates and infants, the very old and other high-risk patients. CSE is a multicompartment block. CSE involves intentional dural puncture followed by epidural drug administration. This introduces the possibility of drug flux from the epidural to the subarachnoid space, which may alter the characteristics of the block. Subarachnoid pressure is normally regarded as greater than epidural pressure by 5-15 cm H2O. This pressure gradient is an obstacle to drug flux into the subarachnoid space. The epidural pressure rises transiently, but dramatically after drug administration, the similar rise in subarachnoid pressure occurs. There is a brief period during, which epidural pressure may exceed subarachnoid pressure. This produces conditions that would allow drug flux into the subarachnoid space. MATERIALS AND METHODSThis clinical study was conducted in Department of Anaesthesiology in association with Department of Obstetrics and Gynaecology at Victoria General Hospital attached to Andhra Medical College, Visakhapatnam, from October 2013 to August 2014. Clearance was obtained from hospital ethics committee for the study. Written informed consent was obtained from all the patients. 40 parturients with ASA I and ASA II in established labour with cervical dilatation less than 5 cm was selected and randomly allocated into two groups using closed envelope method. Informed written consent was taken from all participants. They were divided into 2 groups of 20 each. Group I received intrathecal Inj. Bupivacaine 1.25 mg and Inj. Fentanyl 20 µg. Group II received intrathecal Inj. Ropivacaine 2.5 mg and Inj. Fentanyl 20 µg for combined spinal epidural. IV line was secured with 18G cannula. Patient was preloaded with 500 mL of Hartmann's solution. Basal vital parameter like pulse rate, blood pressure, respiration, O2 saturation were recorded. The patient was positioned in a sitting position with the help of an assistant. Under aseptic conditions, the back was prepared with 5% povidone-iodine solution, spirit and area was draped. L3-L4 interspace was identified. Skin was infiltrated with 2 mL of 1% Xylocaine. After infiltration of local anaesthetic by using needle through needle technique 18-gauge Tuohy needle, epidural space was identified with loss of resistance to air techniqu...

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Section: Vassupporting

confidence: 90%

Section: Vascontrasting

confidence: 54%

Section: Tablementioning

confidence: 56%

Section: Vasmentioning

confidence: 94%

See 2 more Smart Citations

Combined Spinal Epidural Analgesia in Labour: Comparison of Bupivacaine 1.25 Mg With Fentanyl and Ropivacaine 2.5 Mg With Fentanyl Intrathecal

N¹,

Ravi²

2016

jebmh

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“…When low doses of clonidine with or without opioids are used for spinal labor analgesia, we must remember that at the end of pregnancy there is a degree of auto analgesia mediated by endorphins [38]. Even though neuraxial analgesia is the most efficient and safest mode of labor analgesia [1][2][3]39], the use of spinal clonidine mixed with opioids and/or local anesthetics must be must be used cautiously to avoid hypotension. The optimal dose of subarachnoid clonidine to augment labor analgesia obtained with the spinal mixture of opioids-local anaesthetic range from 15 to 30 µg larger doses would induce more deleterious side effects.…”

Section: Spinal Clonidine For Labor Analgesiamentioning

confidence: 99%

Intrathecal Clonidine as Adjuvant for Labor Analgesia, Spinal Anesthesia, and Postoperative Analgesia in Caesarean Section

Lugo¹

2014

JACCOA

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Spinal adjuvants drugs are use to enhance analgesia and anesthesia in several clinical scenarios. Clonidine has been used in anesthesia since 1982 to reduce needs of anesthetics, to provide cardiovascular stability, for anxiolysis, for sedation, and to treat pain. Although its spinal use in obstetrics patients still controversial, there is sufficient information to consider spinal clonidine as a safe adjuvant to enhance spinal labour analgesia and to improve spinal anesthesia for caesarean section, and also to augment spinal postoperative anesthesia after surgical delivery. Using recommended doses, the usual side effects of subarachnoid clonidine are moderate hypotension, non harm fetal arrhythmias, and moderate mother sedation.

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Intrathecal isobaric ropivacaine-fentanyl versus intrathecal isobaric bupivacaine-fentanyl for labor analgesia: A controlled comparative double-blinded study

Cited by 2 publications

References 2 publications

Combined Spinal Epidural Analgesia in Labour: Comparison of Bupivacaine 1.25 Mg With Fentanyl and Ropivacaine 2.5 Mg With Fentanyl Intrathecal

Combined Spinal Epidural Analgesia in Labour: Comparison of Bupivacaine 1.25 Mg With Fentanyl and Ropivacaine 2.5 Mg With Fentanyl Intrathecal

Intrathecal Clonidine as Adjuvant for Labor Analgesia, Spinal Anesthesia, and Postoperative Analgesia in Caesarean Section

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