Evaluation of intrathecal bupivacaine alone, bupivacaine with butorphanol and bupivacaine with dexmedetomidine for lower segment caesarean section: a randomized control trial

Authors

  • Ashem Jack Meitei Department of Anaesthesiology and Critical Care, Regional Institute of Medical Sciences, Imphal-795004, Manipur, India
  • Okram Rubina Department of Anaesthesiology and Critical Care, Regional Institute of Medical Sciences, Imphal-795004, Manipur, India
  • Laithangbam PKS Department of Anaesthesiology and Critical Care, Regional Institute of Medical Sciences, Imphal-795004, Manipur, India
  • Joyshankar Singh I. Department of Anaesthesiology and Critical Care, Regional Institute of Medical Sciences, Imphal-795004, Manipur, India
  • Dilip Ingudum Department of Anaesthesiology and Critical Care, Regional Institute of Medical Sciences, Imphal-795004, Manipur, India
  • Mithun Raj R. Department of Anaesthesiology and Critical Care, Regional Institute of Medical Sciences, Imphal-795004, Manipur, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20164145

Keywords:

Bupivacaine, Butorphanol, Dexmedetomidine, Caesarean Section, Spinal anaesthesia

Abstract

Background: Following caesarean operation, a painless early ambulation is necessary to mother for caring of the neonate. Aim of the study is to compare more effective analgesic by intrathecal bupivacaine or combination with butorphanol or dexmedetomidine.

Methods: Ninety parturients undergoing elective caesarean section were randomly divided into three equal groups (n=30). Group B: received bupivacaine (0.5%) 2 ml + 0.5 ml of normal saline (NS); group BB, bupivacaine (0.5%) 2 ml + 25 mcg butorphanol in 0.5 ml NS and group BD, bupivacaine (0.5%) 2ml + 2.5 mcg of dexmedetomidine in 0.5 ml NS . Visual numerical rating scale (VNRS), heart rate, blood pressure, sensory and motor block levels, fetal outcome by Apgar score and umbilical cord blood pH, any side effects were noted.

Results: The onset time of modified Bromage 3 motor block was statistically significant among the groups (P=0.023) but not significant between Groups BB and BD (P=0.479). The regression time to reach modified Bromage 0 in group BD was significantly longer (P=<0.0001) than either of the groups B or BB but not significant between the later two groups (P=0.479). Time for 2-segment regression, sensory regression time to S1 dermatome and time for first rescue analgesia were significantly longer (P<0.001) in group BD but not significant between the groups B and BB. Sedation was significantly more in group BD (17/30 pts; P<0.001).

Conclusions: Addition of dexmedetomidine to spinal bupivacaine block in caesarean section increase the duration of analgesia and motor block with minimal side effect and no adverse effects on the babies.

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Published

2016-12-21

How to Cite

Meitei, A. J., Rubina, O., PKS, L., I., J. S., Ingudum, D., & R., M. R. (2016). Evaluation of intrathecal bupivacaine alone, bupivacaine with butorphanol and bupivacaine with dexmedetomidine for lower segment caesarean section: a randomized control trial. International Journal of Basic & Clinical Pharmacology, 5(6), 2675–2682. https://doi.org/10.18203/2319-2003.ijbcp20164145

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Original Research Articles