scholarly journals Fetal effects of combined spinal-epidural vs epidural labour analgesia: a prospective, randomised double-blind study

Anaesthesia ◽  
2014 ◽  
Vol 69 (5) ◽  
pp. 458-467 ◽  
Author(s):  
N. P. Patel ◽  
N. El-Wahab ◽  
R. Fernando ◽  
S. Wilson ◽  
S. C. Robson ◽  
...  
Keyword(s):  
Labour Analgesia ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

scholarly journals Comparison of analgesic effect of intrathecal morphine alone or in combination with bupivacaine and fentanyl in patients undergoing total gastrectomy: A prospective randomised, double blind clinical trial

2013 ◽  
Vol 70 (6) ◽  
pp. 541-547 ◽  
Author(s):  
Zoran Slavkovic ◽  
Dusica Stamenkovic ◽  
Veselin Geric ◽  
Milic Veljovic ◽  
Nebojsa Ivanovic ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Epidural Catheter ◽  
Total Gastrectomy ◽  
Analgesic Effect ◽  
Catheter Removal ◽  
Anesthesia Induction ◽  
Double Blind Study ◽  
Double Blind ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

Background/Aim. Combined spinal-epidural-general anesthesia has several advantages over general anesthesia alone. This study was designed to compare the efficacy of intrathecal (IT) morphine alone, or in combination with bupivacaine and fentanyl, as part of a combined spinal-epidural (CSE) analgesia, in patients undergoing elective total gastrectomy. Methods. This prospective, randomized double-blind study included 60 patients undergoing total gastrectomy under general anesthesia and CSE. We compared the analgesic effect of lumbar IT morphine 300 ?g (the group M, n = 20) vs morphine 300 ?g + bupivacaine 2 mg (the group MB, n = 20) vs morphine 300 ?g + bupivacaine 2 mg + fentanyl 25 ?g (the group MBF, n = 20) given after thoracic epidural catheter placement (T6-7) but before general anesthesia induction. Pain visual analogue scale (VAS) at rest (R), with movement (M) and with cough (C), and the number of analgesia requests were assessed for 72 h and after epidural catheter removal. Results. Compared to other groups, the MBF group required significantly fewer additional intra-operative epidural bupivacaine doses (p < 0.001), whereas the M group required significantly more supplemental intraoperative intravenous fentanyl, compared with the MBF (p = 0.022) and MB groups (p = 0.005). Postoperative pain relief was satisfactory in all the groups at all the time. VAS-R and VAS-M did not differ significantly among the groups. Compared to the M group, VAS-C scores 30 min postoperatively were significantly lower in the MBF (p = 0.029) and MB groups (p = 0.002). Duration of analgesia was longer in the MBF and MB groups, but the difference reached no significance. The number of supplemental analgesia requests was similar in all the groups in the first 12 h and during 72 h. Additional analgesia requests after epidural catheter removal were similar in all the groups, and side effects were infrequent. Conclusion. Compared to IT morphine alone, triple IT combination administered as part of CSE provided better intraoperative analgesia, but conferred no benefit with regards to postoperative analgesia.

scholarly journals Comparison of the Efficacy and Safety of Intrathecal Fentanyl 20 μg vs Sufentanil 5 μg as Adjuvant to Bupivacaine 0.5% (12.5 mg) using Combined Spinal Epidural Technique for Lower Limb Orthopedic Surgeries

2016 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Sanjeeta R Umbarkar ◽  
Manju N Gandhi ◽  
Hemlata R Iyer ◽  
Roshan S Thawale
Keyword(s):  
Side Effects ◽  
Lower Limb ◽  
Motor Block ◽  
Demographic Data ◽  
Double Blind Study ◽  
Efficacy And Safety ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Combined Spinal Epidural ◽  
Spinal Epidural

ABSTRACT Aim To compare the efficacy and safety of intrathecal fentanyl 20 μg vs sufentanil 5 μg as adjuvant to bupivacaine 0.5% (12.5 mg) using combined spinal epidural (CSE) technique for lower limb orthopedic surgeries. Background Use of local anesthetics along with opioids intrathecally has been widely reported. We aimed to compare two commonly used opioids as adjuvants to local anesthetic agents in combined spinal epidural techniques. Materials and methods A total of 60 patients were recruited in this prospective, randomized, double-blind study to receive either intrathecal sufentanil 5 μg (Group S) or fentanyl 20 μg (Group F) as adjuvants to 12.5 mg of 0.5% hyperbaric bupivacaine. The onset and duration of sensory and motor block and the pain scores were assessed perioperatively. Duration of analgesia was recorded. The incidence of side effects such as nausea, vomiting, pruritus, shivering. and postdural puncture headache (PDPH) were recorded. Results Demographic data and hemodynamic and respiratory parameters were comparable in both the groups. Onset of analgesia—time to reach highest level of analgesia—was faster in the sufentanil group. Sufentanil group patients had higher grade of motor block. Patients in fentanyl group had higher score of sedation than those of sufentanil group. None of the patients in any group had nausea, vomiting, or pruritus. Conclusion Addition of either fentanyl or sufentanil to intrathecal bupivacaine as an adjuvant in CSE technique enhances the quality of analgesia and motor block with minimal side effects. Hence, this is useful in orthopedic patients, especially in the geriatric age group. How to cite this article Umbarkar SR, Gandhi MN, Iyer HR, Thawale RS. Comparison of the Efficacy and Safety of Intrathecal Fentanyl 20 μg vs Sufentanil 5 μg as Adjuvant to Bupivacaine 0.5% (12.5 mg) using Combined Spinal Epidural Technique for Lower Limb Orthopedic Surgeries. Res Inno Anaesth 2016;1(1):1-4.

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