Анестезия и клинические исследования
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ISSN: 2155-6148
ISSN: 2155-6148
Sudarshan Neik, Magesh John, Kulkarni Kapil, Titus Roj
Background and aim: Epidural analgesia using Bupivacaine for abdominal surgeries causes hypotension at the bargain of analgesia. This study was designed to compare effect of 0.0625% bupivacaine with 2% fentanyl and 0.125% bupivacaine with 2% fentanyl epidural infusion on haemodynamic parameters for 48 hrs in infraumbilical surgeries and VAS as the secondary objective with preserved hemodynamic parameters.
Materials and methods: A randomized, prospective, double-blind study was carried out in sixty consenting adult patients of either sex between the ages of 18-65 years undergoing infra umbilical surgery. Group 1 (n=30) patients received continuous epidural infusion of 0.0625% bupivacaine with 2 ug/ml fentanyl and group 2 (n=30) received 0.125% bupivacaine with 2 ug/ml fentanyl. Postoperatively hemodynamic parameters and VAS was recorded at interval of 3 hrs till 48 hrs. The infusion was stopped if there was hypotension even with lowest infusion rate (5 ml/ hr).
Results: In total, 60 patients were randomized (n=30 in each groups). After 9 hrs the infusion was stopped in 5 patients who increased to 6 after 12 hrs, 9 after 15 hrs, 12 after 21 hrs. Statistical difference was noted between two groups from 9 hrs to 48 hrs in SBP and DBP (p<0.05). Significant variation in hemodynamics was noted in whom the infusion was stopped. Significant difference in (Visual Analogue Scale) VAS was noted after 12 hrs, 15 hrs and 18 hrs among the patients in whom the infusion was stopped.
Conclusion: Satisfiable VAS could be achieved in group 1 with preserved haemodynamic parameters. On contrary infusion was stopped in 12 patients in group 2 in view of hypotension which led to increase in VAS due to pain.