Fentanyl Citrate and Magnesium Sulphate as Adjuvants to 0.5% heavy Bupivacaine in Spinal Anaesthesia

What is it about?

Fentanyl Citrate and Magnesium Sulphate as Adjuvants to 0.5% heavy Bupivacaine in Spinal Anaesthesia

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Photo by Callum Parker on Unsplash

Photo by Callum Parker on Unsplash

Why is it important?

Spinal anaesthesia is preferred regional anaesthesia technique in lower abdominal surgeries. Advantages are conscious and spontaneously breathing patient [25], good muscle relaxation, cost effectiveness and adjuvants injected intrathecally prolong the anaesthetic effects [26,27]. Aim of the study: To compare Fentanyl Citrate and Magnesium sulfate as adjuvants to 3 ml of 0.5% bupivacaine in infraumbilical surgeries under spinal anaesthesia, about onset and duration of sensory and motor block, intraoperative hemodynamics, postoperative pain and side effects. Materials & Methods: After Institutional ethics committee approval, a double-blinded comparative study was conducted in 100 patients at Osmania General hospital during 2014-2017. Patients were divided into two groups of 50 no.’s each Group F- 3 ml 0.5% Heavy Bupivacaine & Fentanyl citrate 25 mcg, Group M –3 ml 0.5% Heavy Bupivacaine & MgSO4 100 mg were deposited intrathecally. Intraoperatively Sensory and Motor block onset and duration, HR, SBP, DBP & MAP, SpO2, side effects were assessed. Results: In group M– onset of sensory and motor block is significantly prolonged , duration of analgesia, motor block is comparable to group F and patients in group M were hemodynamically stable perioperatively, and at end of 24 hrs postoperatively VAS score was ≥ 3 at indicates a quality post operative analgesia. Conclusion: Fentanyl citrate as adjuvant to 0.5% heavy bupivacaine effectively augmented quality of spinal anaesthesia; its advantages are limited by incidence of side effects. MgSO4 100 mg provides excellent perioperative analgesia and stable hemodynamics and is an attractive non-opioid adjuvant alternative to fentanyl.

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