THE RECOVERY PROFILE OF HYPERBARIC BUPIVACAINE AND BUPIVACAINE WITH FENTANYL IN SPINAL ANAESTHESIA

BACKGROUND Knowledge of the recovery profile from a spinal anaesthetic is helpful in predicting time to meeting discharge criteria from an ambulatory surgery center. Upper abdominal surgery takes 2 to 3 hours. Which was previously considered inappropriate for the ambulatory setting, surgery is now being performed on outpatients under spinal anaesthesia. Therefore, it is important for anaesthesiologists to know the recovery profile of Bupivacaine and Bupivacaine with Fentanyl. There is always need of search of such a drug combination which reduces the hospital stay of patient with minimal side effects. This study explores the use of long acting local anaesthetic Bupivacaine and Bupivacaine with Fentanyl for upper abdominal surgery. METHODS 120 patients undergoing upper abdominal surgery were enrolled in a double-blinded clinical trial study. Patients were randomly allocated into two groups. Group A received 17.5 mg (3.5 ml) of Bupivacaine and Group B received Bupivacaine 15 mg and 25 pg of Fentanyl (3.5 ml) as intrathecal drug for spinal anaesthesia. Sensory and motor blockade scores, postoperative pain scores and need of analgesic injection 6 and 12 hours after surgery, postoperative voiding time, and the incidence of hypotension, bradycardia, respiratory depression, and nausea and vomiting were recorded. Ambulation time and discharge from hospital were also recorded. RESULTS Complete analgesia (time from injection to first report of pain) time was more in group BF i.e., 146 +/- 8.5 min, and voiding time was also more in group BF i.e., 10.3 hours (618 +/- 34 min), and 3% patients developed pruritus postoperatively. The average time of discharge was same in both groups but need of analgesic was less in group B. Patients in group BF were more comfortable during post-operative period except 2 patients who develops pruritus. CONCLUSIONS Bupivacaine with intrathecal fentanyl 25 mu g produces a satisfactory surgical block, significantly decreases the need of analgesic supplementation, but increases the voiding time. early ambulation occurs in this group. There are no side effect of intrathecal fentanyl. It is very good for patients. Thus, overall effect of Bupivacaine and Fentanyl is superior to Bupivacaine alone, apart from positive effects of fentanyl, it decreases the requirement of bupivacaine and has no side effects.