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...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-09-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/15353/46404_CE[Ra1]_F[SK]_PF1(SC_RK)_PFA(SC_KM)_PN(KM).pdf |
| _version_ | 1819022884025139200 |
|---|---|
| author | Avani Tiwari Sarvesh Singh Meena Singh Mukesh Sanghwan |
| author_facet | Avani Tiwari Sarvesh Singh Meena Singh Mukesh Sanghwan |
| author_sort | Avani Tiwari |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T04:30:05Z |
| format | Article |
| id | doaj.art-ac9da78d3d464e8d815c8b73d1a99b98 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-21T04:30:05Z |
| publishDate | 2021-09-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-ac9da78d3d464e8d815c8b73d1a99b982022-12-21T19:15:58ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-09-01159UC01UC0410.7860/JCDR/2021/46404.15353Comparison of Bupivacaine and 2-Chloroprocaine with and without Fentanyl for Subarachnoid Block in Inguinal Hernia Repair Surgery: A Randomised Controlled StudyAvani TiwariSarvesh SinghMeena SinghMukesh SanghwanIntroduction: 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.https://www.jcdr.net/articles/PDF/15353/46404_CE[Ra1]_F[SK]_PF1(SC_RK)_PFA(SC_KM)_PN(KM).pdfhaemodynamic parametersmotor and sensory blockonset and durationpostoperative urinary retention |
| spellingShingle | Avani Tiwari Sarvesh Singh Meena Singh Mukesh Sanghwan Comparison of Bupivacaine and 2-Chloroprocaine with and without Fentanyl for Subarachnoid Block in Inguinal Hernia Repair Surgery: A Randomised Controlled Study Journal of Clinical and Diagnostic Research haemodynamic parameters motor and sensory block onset and duration postoperative urinary retention |
| title | Comparison of Bupivacaine and 2-Chloroprocaine with and without Fentanyl for Subarachnoid Block in Inguinal Hernia Repair Surgery: A Randomised Controlled Study |
| title_full | Comparison of Bupivacaine and 2-Chloroprocaine with and without Fentanyl for Subarachnoid Block in Inguinal Hernia Repair Surgery: A Randomised Controlled Study |
| title_fullStr | Comparison of Bupivacaine and 2-Chloroprocaine with and without Fentanyl for Subarachnoid Block in Inguinal Hernia Repair Surgery: A Randomised Controlled Study |
| title_full_unstemmed | Comparison of Bupivacaine and 2-Chloroprocaine with and without Fentanyl for Subarachnoid Block in Inguinal Hernia Repair Surgery: A Randomised Controlled Study |
| title_short | Comparison of Bupivacaine and 2-Chloroprocaine with and without Fentanyl for Subarachnoid Block in Inguinal Hernia Repair Surgery: A Randomised Controlled Study |
| title_sort | comparison of bupivacaine and 2 chloroprocaine with and without fentanyl for subarachnoid block in inguinal hernia repair surgery a randomised controlled study |
| topic | haemodynamic parameters motor and sensory block onset and duration postoperative urinary retention |
| url | https://www.jcdr.net/articles/PDF/15353/46404_CE[Ra1]_F[SK]_PF1(SC_RK)_PFA(SC_KM)_PN(KM).pdf |
| work_keys_str_mv | AT avanitiwari comparisonofbupivacaineand2chloroprocainewithandwithoutfentanylforsubarachnoidblockininguinalherniarepairsurgeryarandomisedcontrolledstudy AT sarveshsingh comparisonofbupivacaineand2chloroprocainewithandwithoutfentanylforsubarachnoidblockininguinalherniarepairsurgeryarandomisedcontrolledstudy AT meenasingh comparisonofbupivacaineand2chloroprocainewithandwithoutfentanylforsubarachnoidblockininguinalherniarepairsurgeryarandomisedcontrolledstudy AT mukeshsanghwan comparisonofbupivacaineand2chloroprocainewithandwithoutfentanylforsubarachnoidblockininguinalherniarepairsurgeryarandomisedcontrolledstudy |