Randomized controlled study comparing the efficacy of neuraxial blockade by using intrathecal administration of 0.5% hyperbaric bupivacaine 15mg and fentanyl 25mcg - in a single syringe versus separate syringe techniques in inguinal hernia surgeries

Abstract

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. 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. 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. 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. 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.