Comparison of bupivacaine with fentanyl and bupivacaine with fentanyl and adrenaline in epidural

Abstract

Studies have shown that
adrenaline when added to epidural anesthesia
with bupivacaine in thoracic epidural
has caused an increase in duration of
anesthesia and increased in motor block
intensity. It was found that when used in
labour analgesia was found to be disadvantageous,
as motor block was more
when used in combination with bupivacaine.
This was hypothesized to be because
of vasoconstriction caused by
adrenaline and also by alpha 2 agonism.
Hence our study was designed to find
the effect of epidural adrenaline in combination
with bupivacaine and fentanyl in
epidural anesthesia. In our study we
compared 40 patients who underwent
elective orthopedic surgeries in supine
position. 20 patients received 0.5 bupivacaine
with 1 micro gram per ml fentanyl
as compared to 20 who received 0.5
bupivacaine with 1 micro gram per ml
fentanyl and 1 in 200000 adrenaline. The
block onset, degree of motor block, duration
of the anesthesia and hemodynamics
in the two groups were compared and
analyzed.
And our study found out that addition of
adrenaline in concentration of 1 in 200000
cause quicker onset of block, denser motor
blockade, with no significant prolongation
in duration of regression or post op analgesia.