Authors : Virendra Kumar Verma, Rajeev Navaria, Udita Naithani, Anjuri Goyal, Saurav Aditya Das
DOI : 10.18231/j.ijca.2020.019
Volume : 7
Issue : 1
Year : 2020
Page No : 104-111
Introduction: Currently, the safety of spinal anaesthetic techniques is well established for caesarean
section in pregnancy induced hypertension (PIH) patient. Addition of fentanyl to local anaesthetic allows
achievement of adequate anaesthesia with lower dose of local anaesthetic in spinal anaesthesia, thereby
reducing the occurence of hypotension and need for vasopressor.
Materials and Methods: A prospective, randomized, double blind, case control study was carried out
in 80 parturients having PIH undergoing caesarean section in spinal anaesthesia were randomized into
2 groups depending on intrathecal drug received by them as Group C (Conventional dose group- received
hyperbaric bupivacaine 10 mg)and Group Lflow dose group, hyperbaric bupivacaine (7.5 mg) with fentanyl
(25 mcg)g and compared regarding sensory- motor block characteristics, incidence of hypotension (fall in
MAP > 25% from baseline) vasopressor requirement Phenylephrine and Ephedrine.
Result: Patient in Group L had significantly less number of hypotension episodes as compared to Group
C(20 vs 31, p= 0.011). Hence vasopressor requirement was also significantly less in Group L than in
Group C [Phenylephrine (1600 mcg vs 2500 mcg, p=0.044), Ephedrine (66 mg vs 18 mg, p= 0.030)].
Conclusion: Low dose spinal anaesthesia using 7.5 mg hyperbaric bupivacaine with 25 mcg fentanyl
seems to be superior alternative to conventional dose of 10 mg hyperbaric bupivacaine for caesarean section
in parturients having pregnancy induced hypertension, because it was associated with better hemodynamic
stability, reduced vasopressor requirement.
Keywords: Pregnancy induced hypertension, PIH, Low dose spinal anaesthesia, Hypotension, Fentanyl, Low dose bupivacaine, Caesarean section.