Comparison of Bupivacaine and 2-Chloroprocaine with and without Fentanyl for Subarachnoid Block in Inguinal Hernia Repair Surgery: A Randomised Controlled Study
Introduction: Providing an adequate intraoperative anaesthesia with a prolonged pain-free interval is the prime priority of an anaesthesiologist. Since the decline in use of 2-chloroprocaine in 1956, due to side-effects of its preservative sodium bisulfite, the preservative free drug has recentl...
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| Autores principales: | , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
JCDR Research and Publications Private Limited
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/ac9da78d3d464e8d815c8b73d1a99b98 |
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| Sumario: | Introduction: Providing an adequate intraoperative anaesthesia
with a prolonged pain-free interval is the prime priority of an
anaesthesiologist. Since the decline in use of 2-chloroprocaine
in 1956, due to side-effects of its preservative sodium bisulfite,
the preservative free drug has recently witnessed a comeback in
clinical practice.
Aim: To compare the efficacy of bupivacaine and 2-chloroprocaine
with and without fentanyl in subarachnoid block for inguinal
hernia repair surgery.
Materials and Methods: This randomised controlled study was
carried out on 102 male patients of 18-65 years of age, American
Society of Anesthesiologists (ASA) grade I or II, scheduled for
inguinal hernia repair. The study was conducted from May 2019
to November 2020. The patients were randomly divided into
three groups of 34 each. In group A, the subarachnoid block was
administered with injection 0.5% bupivacaine (H) 10.5 mg. In
group B, patients were administered, injection 2-chloroprocaine
40 mg diluted with 0.5 mL of saline. In group C, the patients were
administered with injection 2-chloroprocaine 40 mg with 25 µg
of injection fentanyl (0.5 mL). The adequacy of intraoperative
anaesthesia in terms of onset and duration of sensory and
motor blockade, haemodynamic parameters, postoperative
urinary retention and other side-effects were evaluated. The
parameters were compared using Analysis of variance test
(>2 groups). If statistically significant difference was found in
ANOVA, appropriate post-hoc (LSD/Bonferroni) was used to
assess statistical significance of pair-wise comparisons.
Results: The mean time of onset of the motor and sensory block
was faster in group B (3.57±0.66, 2.68±0.58 min), by almost
1 minute than in the bupivacaine and fentanyl group (4.57±0.79,
3.59±0.61 min) (4.99±1.01, 4.04±0.99 min) respectively. The mean
difference was statistically significant (p-value <0.05). The mean
duration of the motor and sensory blocks between the groups
revealed statistically significant difference between groups A and
B as well as groups A and C. However, between groups B and C,
there was no significant difference as far as motor block duration
is concerned. Group B had significantly shorter duration of the
motor and sensory block amongst the three groups.
Conclusion: Addition of intrathecal fentanyl significantly prolonged
the onset and duration of sensory and motor block, with minimally
extending the time to complete recovery. |
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