Incidence of Intraoperative Hypotension and Bradycardia in Spinal Anaesthesia with 0.5% Bupivacaine alone and 0.5% Bupivacaine with Fentanyl for Abdominal Hysterectomy: A Cross-sectional Study
Dr. Remani Kelan Kamalakshy,
Assistant Professor, Department of Anaesthesiology,
Government Medical College, Thrissur-680596, Kerala, India.
Introduction: Bupivacaine hydrochloride, when used for spinal anaesthesia, is associated with varying degree of hypotension and bradycardia. Intrathecal opioids provides haemodynamic stability and improves quality of perioperative analgesia.
Aim: To compare the incidence of intraoperative hypotension, bradycardia and its side-effects when using 0.5% hyperbaric bupivacaine alone and with 25 μg fentanyl added to it for subarachnoid block for abdominal hysterectomy.
Materials and Methods: This cross-sectional study was conducted at Government Medical College, Thrissur, Kerala, India from June 2019 to May 2020 on 96 American Society of Anaesthesiologists Physical Status (ASA-PS) I and II patients posted for total abdominal hysterectomy under lumbar subarachnoid block. They were divided into Group A and B, carrying 48 patients in each group. Group A received 3.3 mL of 0.5% hyperbaric bupivacaine alone. Group B received 3.3 mL of 0.5% hyperbaric bupivacaine and 25 μg fentanyl. Haemodynamic characteristics, analgesic properties and side-effects were compared between Group A and Group B. Data were entered in Microsoft Excel Software, and analysed using Statistical Package for the Social Sciences (SPSS) software version 16.0 and p-value <0.05 was considered as statistically significant.
Results: The incidence of hypotension in group A was 41.7% and in group B was 39.6%. Incidence of analgesia was significantly higher in group B (group A - 181.2±4.9, group B - 220.9±13.9). In group A, no one had nausea and vomiting. In group B, 8.3% experienced nausea and vomiting and none in both groups experienced pruritus.
Conclusion: There was no difference in the development of hypotension and bradycardia when fentanyl was added to bupivacaine for spinal anaesthesia and had the advantage of increased duration of postoperative analgesia.