Abstract :
Introduction: Adjuvants premixed with local anaesthetic solution can alter the density of the hyperbaric
solution affecting the spread of block. Administering local anaesthetic and adjuvant in a separate syringe
may minimize these changes with respect to densities. Hence we aimed to compare the efficacy of the drugs
when administered sequentially and as a mixture.
Objective: To compare the efficacy of neuraxial blockade with pre- mixed fentanyl and 0.5% hyperbaric
bupivacaine and sequential administration of fentanyl and 0.5% hyperbaric bupivacaine.
Materials and Methods: After obtaining the institutional ethics committee approval, patients were
randomly allocated into Group M = received spinal anesthesia using 15mg of 0.5% bupivacaine heavy and
25mcg fentanyl premixed in the same syringe. Group S = received spinal anesthesia sequentially. Drugs
were injected through 25 gauge quincke’s needle in sitting position, inserted at L3-L4 space. Onset of block
,hemodynamics, duration of analgesia and complications were monitored.
Results: Group S had slower onset and slow progression of the block with more time taken to regression
of the block compared to the group Incidence of hypotension ,bradycardia was less in group S compared to
group M.
Conclusion: We conclude that administrating adjuvants to local anaesthesia sequentially is better than
mixing them in a single syringe in terms of surgical anaesthesia, hemodynamic stability and post operative
pain relief.
Keyword :
Adjuvants premixed, Bupivacaine, Fentanyl, Sequential administration.