Comparative study between fractionated and single bolus dose of local anaesthetic in elective lower segment caeserean section

Authors : Monika Gandhi, Monika Gandhi, Kaushal Kishore Kabir, Kaushal Kishore Kabir, K K. Arora, K K. Arora, Karuna Tiwari, Karuna Tiwari

DOI : 10.18231/j.ijca.2019.074

Volume : 6

Issue : 3

Year : 2019

Page No : 386-390

Context: To evaluate whether Fractionated dose is an alternative to single bolus dose in spinal anaesthesia in terms of haemodynamic stability, total analgesic duration and quality of sensory and motor block.
Aims: we aim to compare between fractionated and single bolus dose of local anaesthetic in subarachnoid block in elective LSCS.
Settings and Design: This prospective comparative study was conducted at a tertiary care hospital in central India.
Materials and Methods: 200 healthy female patients were randomly divided into groups (100 in each) group F (fractionated group) and group B (single bolus group). Subarachnoid block was given in sitting position in both the groups with 0.5% hyperbaric bupivacaine according to the height of the patient (0.07mg/cm) height. Group B was given single bolus dose over 10 seconds. Group F received 2/3rd of the dose initially followed by 1/3rd dose after 90 sec, the rate was 0.2ml/sec in both the groups. In group F, syringe was kept attached to the spinal needle after 2/3rd dose for 90 sec, after which the remaining 1/3rd dose was given. Data assessed was onset, level and duration of sensory block. Onset of sensory block assessed by pin prick sensation. Onset, duration ®ression of motor block was also assessed. Duration of analgesia and the number of hypertensive episodes was also noted.

Statistical Analysis used: Collected data was analysed using Microsoft excel and Statistical Package for Social Sciences (SPSS ver. 21).
Results: Significant statistical difference was found between the two groups in terms of haemodynamic stability, characteristic of block, time of first rescue analgesia and total duration of analgesia.
Conclusions: Fractionated group was found to be more haemodynamically stable with good quality sensory and motor block.

Keywords: Hypotension, Motor blockade, Single bolus dose, Fractionated dose.


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