COMPARISON OF BOLUS DOSE VERSUS FRACTIONATED DOSE OF INJECTION BUPIVACAINE HEAVY (0.5%) IN SPINAL ANAESTHESIA FOR PATIENTS UNDERGOING EMERGENCY CAESAREAN SECTION: A RANDOMISED STUDY.

Dr. Deepak Khare; Dr. Neelesh Nema

Volume : VIII, Issue : VI, June - 2019

COMPARISON OF BOLUS DOSE VERSUS FRACTIONATED DOSE OF INJECTION BUPIVACAINE HEAVY (0.5%) IN SPINAL ANAESTHESIA FOR PATIENTS UNDERGOING EMERGENCY CAESAREAN SECTION: A RANDOMISED STUDY.

Dr. Deepak Khare, Dr. Neelesh Nema

Abstract :

Background and Aims: Bolus dose of spinal anaesthesia (SA) has rapid onset but precipitate hypotension, whereas fractionated dose of local anaesthetic with a time gap provides a dense block, maintains hemodynamic stability with prolonged prolonged duration of analgesia. We compared fractionated dose with bolus dose in SA for haemodynamic stability and duration of analgesia in patients undergoing emergency lower segment caesarean section (LSCS). Methods: After clearance from the Institutional Ethics Committee, study was carried out in sixty patients undergoing emergency LSCS and patients were divided into two groups, GROUP B and GROUP F. Group B received single bolus dose of bupivacaine heavy (0.5%) and Group F fractionated dose of bupivacaine heavy (0.5%) with two‑third of the total dose given initially followed by one‑third dose after 90 sec. Student�s unpaired t‑test was used to analyse Time of onset and regression of sensory and motor blockage, intraoperative haemodynamics and duration of analgesia. Result: All the patients were haemodynamically stable in Group F as compared to Group B. Four patients in Group F and thirteen patients in Group B required vasopressor. Duration of sensory and motor block and duration of analgesia were longer in Group F (278.83 � 20.67 min) compared to Group B (236.5 � 31.92 min) P < 0.05. Conclusion: Fractionated dose of bupivacaine in spinal anaesthesia provides greater hemodynamic stability and longer duration of analgesia compared to bolus dose.