Hemodynamic and analgesic effect of intrathecal fentanyl with bupivacaine in patients undergoing elective cesarean section; a prospective cohort study

Spinal anesthesia with bupivacaine has side effects such as hypotension, respiratory depression, vomiting, and shivering. The side effects are dose-dependent, therefore different approaches have been attempted to avoid spinal-induced complications including lowering the dose of local anesthetic and...

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Bibliographic Details
Published in:	PloS one Vol. 17; no. 7; p. e0268318
Main Authors:	Ebrie, Ayub Mohammed, Woldeyohanis, Misrak, Abafita, Bedru Jemal, Ali, Siraj Ahmed, Zemedkun, Abebayehu, Yimer, Yusuf, Ashebir, Zewetir, Mohammed, Salih
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 07-07-2022 Public Library of Science (PLoS)
Subjects:	Additives Analgesia Analgesics Anesthesia Anesthesia, Obstetrical - adverse effects Anesthesia, Spinal - adverse effects Anesthetics, Local Blood pressure Bradycardia Breastfeeding & lactation Bupivacaine Cesarean section Cesarean Section - adverse effects Chi-square test Cohort analysis Complications Complications and side effects Data collection Double-Blind Method Drug dosages Female Fentanyl General anesthesia Hemodynamics Hospitals Humans Hypertension Hypotension Hypotension - chemically induced Injections, Spinal Kruskal-Wallis test Medicine and Health Sciences Narcotics Pain perception Patient outcomes Patient satisfaction Pregnancy Prospective Studies Rank tests Shivering Side effects Variance analysis Vomiting Ethiopia Addis Ababa Ethiopia
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Summary:	Spinal anesthesia with bupivacaine has side effects such as hypotension, respiratory depression, vomiting, and shivering. The side effects are dose-dependent, therefore different approaches have been attempted to avoid spinal-induced complications including lowering the dose of local anesthetic and mixing it with additives like Neuraxial opioids. To compare the Hemodynamic and analgesic effects of intrathecal fentanyl as an adjuvant with low and conventional doses of bupivacaine in patients undergoing elective cesarean section under spinal anesthesia. An institutional-based prospective cohort study was conducted on 90 patients. Data was collected with chart review, intraoperative observation, and postoperatively patient interview. Data was entered into EPI INFO and transport to SPSS version 23 for analysis of variables using one-way ANOVA, Kruskal Wallis H rank test, and chi-square. Hypotension but not bradycardia, was significantly frequent in a conventional dose of bupivacaine alone (CB) group and a conventional dose of bupivacaine with fentanyl (CBF) groups than that of the lower dose of bupivacaine with fentanyl (LBF) groups. Duration of analgesia was significantly longer in LBF (248± 35.6 minutes) and in CBF groups (260.3±40.3 minutes) than in CB group (167.10 ± 31.45 minutes). Time for the first analgesic request was significantly later in LBF (304±47.8 minutes) and CBF (294.6±99.5 minutes) groups than that in CB group (177±25.88 minutes). The Lower dose of bupivacaine is associated with less risk of hypotension and faster recovery. Adding fentanyl with the lower dose of bupivacaine in spinal anesthesia for cesarean section could provide comparable anesthesia with the lower risk of hypotension and longer postoperative analgesia.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0268318