Title: A Dose Response Study of Intrathecal Fentanyl Added to 0.5% Ropivacaine in Pediatric Spinal Anesthesia for Infraumblical Surgeries- A Double Blinded Randomised Study
Authors: Kanta Bhati, Deepika Hatila
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.91
Abstract
Aim and Objectives: The aim was to compare adequacy of anesthesia and analgesia provided by two different doses of Fentanyl (0.2 and 0.4mcg/kg) as an adjuvant to 0.5% Isobaric Ropivacaine (0.5mg/kg) in pediatric spinal anesthesia for infra-umbilical surgeries.
Materials and Methods: This prospective, randomized, double blind, single center based study was conducted on 90 patients of either sex, aged 3-10 year, ASA grade I and II, undergoing elective infra-umbilical surgeries. All patients were divided randomly into three groups- Group R- Inj.0.5% Ropivacaine 0.5 mg/kg, Group RF0.2- Inj.0.5%Ropivacaine 0.5 mg/kg + Inj.Fentanyl 0.2 mcg/kg and Group RF0.4- Inj.0.5%Ropivacaine 0.5 mg/kg + Inj.Fentanyl 0.4 mcg/kg. Sensory-motor blockade characteristics and duration of analgesia were primary outcomes. Hemodynamic variables, success rate and total analgesic consumption were secondary outcomes.
Result: Onset and peak of sensory blockade was faster Fentanyl groups. Duration of analgesia was prolonged in group RF0.4 (161.17±10.11 min) than group RF0.2 (136.6± 17.54min) and Group R (117.5± 14.28min). Motor block characteristics were comparable. Total analgesic consumption in first 24 hours was significantly decreased in group RF0.4 (653.2±184.96mg) compared to group RF0.2 (754.4±197.31mg) and group R (843.75±239.75mg). Hemodynamic stability was seen in all groups. Incidence of nausea-vomiting and pruritus increased with higher dose of fentanyl.
Conclusion: We concluded that intrathecal Fentanyl as an adjuvant to Ropivacaine prolongs the duration and quality of analgesia without significant effect on motor block. Although increasing the dose of fentanyl from 0.2 μg/kg to 0.4 μg/kg improves quality of block and increases duration of analgesia but the incidence of nausea-vomiting and pruritus are also increases.
Keywords: Pediatric spinal anesthesia, Ropivacaine, Fentanyl
