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Addition of bupivacaine 1.25 mg to fentanyl confers no advantage over fentanyl alone for intrathecal analgesia in early labour

[L'ajout de 1,25 mg de bupivacaïne au fentanyl n'apporte aucun avantage sur le fentanyl seul pour l'analgésie intrathécale au début de l'accouchement]

From the Department of Anaesthesia, KK Women's and Children's Hospital, Singapore.

Address correspondence to: Dr. Alex T.H. Sia, Department of Anaesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899. Phone: 65-3941081; Fax: 65-2912661; Email: athsia{at}kkh.com.sg

Purpose: a) To evaluate the effect of adding 1.25 mg of bupivacaine to intrathecal fentanyl on the duration of analgesia in an Asian population and b) to examine if the baricity of the local anesthetic at this dose has any bearing on the duration and quality of block.

Methods: Forty-eight parturients in early labour received combined spinal epidural (CSE) analgesia to evaluate a) the effect of adding 1.25 mg of bupivacaine to intrathecal (IT) fentanyl 25 µg on the duration of analgesia and b) the effect of baricity of intrathecal local anesthetic on the duration and quality of the block. Patients were randomly allocated to receive: IT fentanyl 25 µg plus normal saline (Group f, n=16), IT fentanyl 25 µg plus plain bupivacaine 1.25 mg (Group f+pb, n=16) and IT fentanyl 25 µg plus heavy bupivacaine 1.25 mg (Group f+hb, n=16). The two components of the IT injectate (total of 2.25 mL) were given sequentially.

Results: Group f+hb had the lowest sensory dermatomal block (T7 vs T4 (Group f), T5 (Group f+pb), P <0.01). There were no differences in the duration of analgesia and incidence of side effects among the groups.

Conclusion: We found no advantage of adding 1.25 mg bupivacaine to fentanyl 25 µg. At this dose, the baricity of bupivacaine has no effect on the duration of analgesia.

This article has been cited by other articles:

				W. H. L. Teoh and A. T. H. Sia Hyperbaric Bupivacaine 2.5 mg Prolongs Analgesia Compared with Plain Bupivacaine When Added to Intrathecal Fentanyl 25 {micro}g in Advanced Labor Anesth. Analg., September 1, 2003; 97(3): 873 - 877. [Abstract] [Full Text] [PDF]