Volume : 09, Issue : 12, December – 2022
Title:
13.EFFECT OF FENTANYL, HYPERBARIC LIGNOCAINE AND INTRATHECAL BUPIVACAINE DURING SPINAL BLOCKADE
Authors :
Hisham Mohammad Hafiz, Abdalmohimin mohammadhabeeb fattni, Osamah Haroon Nagro, Ahmed Dakhil Allah Alshambari, mizhir oudah alzahrani, Ahmad mosa mohmad alrabi, Abdulaziz Olayan Almalawi, Ahmed Hamad Alluqmani, Ahmed hamaad alhasani, Alaa yahya madkhali
Abstract :
The effects of volume and baricity of spinal bupivacaine on block onset, height, duration when it’s associated with fentanyl and hyperbaric lignocaine are very effective but has many adverse effects. We conducted this review among published studies found in electronic medical databases such as; PubMed, Embase, up to the beginning of 2022. According to studies, the addition of clonidine to intrathecal bupivacaine provides longer-lasting postoperative analgesia than fentanyl, albeit with a greater sedative effect. Clonidine prolongs postoperative analgesia more than fentanyl, hence fentanyl is suggested when sedation is undesirable while clonidine is advised when sedation is acceptable.
Cite This Article:
Please cite this article in press Hisham Mohammad Hafiz et al, Effect Of Fentanyl, Hyperbaric Lignocaine And Intrathecal Bupivacaine During Spinal Blockade.., Indo Am. J. P. Sci, 2022; 09(12).
Number of Downloads : 10
References:
1. Ngan Kee WD, Khaw KS, Ng FF, Ng KK, So R, Lee A. Synergistic interaction between fentanyl and bupivacaine given intrathecally for labor analgesia. Anesthesiology. 2014;120:1126–36.
2. Desai S, Lim Y, Tan CH, Sia AT. A randomised controlled trial of hyperbaric bupivacaine with opioids, injected as either a mixture or sequentially, for spinal anaesthesia for caesarean section. Anaesth Intensive Care. 2010;38:280–4.
3. Belzarena SD. Clinical effects of intrathecally administered fentanyl in patients undergoing cesarean section. Anesth Analg. 1992;74:653–7.
4. Burns SM, Cowan CM, Wilkes RG. Prevention and management of hypotension during spinal anaesthesia for elective Caesarean section: a survey of practice. Anaesthesia 2001; 56: 794—8
5. Choi DH, Ahn HJ, Kim MH. Bupivacaine-sparing effect of fentanyl in spinal anesthesia for cesarean delivery. Reg Anesth Pain Med 2000; 25: 240—5.
6. Elia N, Culebras X, Mazza C, Schiffer E, Tramèr MR. Clonidine as an adjuvant to intrathecal local anesthetics for surgery: Systematic review of randomized trials. Reg Anesth Pain Med. 2008;33:159–67.
7. Wang JK, Nauss LA, Thomas JE. Pain relief by intrathecally applied morphine in man. Anesthesiology. 1979;50:149–51.
8. Selvaraju KN, Sharma SV. Comparison of forced expiratory spirometric flow changes following intrathecal bupivacaine and bupivacaine with fentanyl. South Afr J Anesth Analg. 2008;14:33–7.
9. De Kock M. Site of hemodynamic effects of alpha 2-adrenergic agonists. Anesthesiology. 1991;75:715–6.
10. Bonnet F, Buisson VB, Francois Y, Catoire P, Saada M. Effects of oral and subarachnoid clonidine on spinal anesthesia with bupivacaine. Reg Anesth. 1990;15:211–4.
11. Sethi BS, Samuel M, Sreevastava D. Efficacy of analgesic effects of low dose intrathecal clonidine as adjuvant to bupivacaine. Indian J Anaesth. 2007;51:415–9.
12. Siddik-Sayyid SM, Aouad MT, Jalbout MI et al. Intrathecal versus intravenous fentanyl for supplementation of subarachnoid block during cesarean delivery. Anesth Analg 2002; 95: 209—13.
13. Shende D, Cooper GM, Bowden MI. The influence of intrathecal fentanyl on the characteristics of subarachnoid block for caesarean section. Anaesthesia 1998; 53: 706—10.
14. Cowan CM, Kendall JB, Barclay PM, Wilkes RG. Comparison of intrathecal fentanyl and diamorphine in addition to bupivacaine for caesarean section under spinal anaesthesia. Br J Anaesth 2002; 89: 452—8.
15. Hildebrand K, Elsberry D, Deer T. Stability, compatibility and safety of intrathecal bupivacaine administered chronically via an implantable delivery system. Clin J Pain in press.
16. Trissel LA. Handbook on Injectable Drugs, 10th edn. Bethesda: American Society of Health-System Pharmacists, Inc, 1998.
17. Keera AA, Elnabtity AM. Two syringe spinal anesthesia technique for cesarean section: a controlled randomized study of a simple way to achieve more satisfactory block and less hypotension. Anesth Essays Res. 2016;10:312–8.
18. Breen TW, Shapiro T, Glass B, Foster-Payne D, Oriol NE. Epidural anesthesia for labor in an ambulatory patient. Anesth Analg. 1993;77:919–24.
19. Agrawal A, Agrawal S, Asthana V, Payal YS, Sharma J, Gupta V. Comparison of intrathecal fentanyl and sufentanil in addition to bupivacaine for caesarean section under spinal anaesthesia. J Anaesth Clin Pharmacol. 2009;25:154–6.
20. Shidhaye RV, Shah BB, Joshi SS, Deogaonkar SG, Bhuva AP. Comparison of clonidine and fentanyl as an adjuvant to intrathecal bupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing caesarian section. Sri Lankan J Anaesthesiol. 2013;22:15–20.
21. Shah BB, Shidhaye RV, Divekar DS, Panditrao M, Panditrao MM, Suryawanshi C. Effect of addition of clonidine to bupivacaine used for patients undergoing spinal anaesthesia: A randomized, double blind, controlled study. Sri Lankan J Anaesthesiol. 2011;19:17–21.
22. Kothari N, Bogra J, Chaudhary AK. Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section. Saudi J Anaesth. 2011;5:31–5.
23. Bajwa SJ, Bajwa SK, Kaur J, Singh A, Singh A, Parmar SS. Prevention of hypotension and prolongation of postoperative analgesia in emergency cesarean sections: A randomized study with intrathecal clonidine. Int J Crit Illn Inj Sci. 2012;2:63–9.
24. Biswas BN, Rudra A, Bose BK, Nath S, Chakrabarty S, Bhattacharjee S. Intrathecal fentanyl with hyperbaric bupivacaine improves analgesia during caesarean delivery and in early post operative period. Indian J Anaesth. 2002;46:469–72.
25. Kanayama N, Belayet HM, Khatun S et al. A new treatment of severe pre-eclampsia by long-term epidural anaesthesia. J Hum Hypertens 1999;13:167–171.
26. Worthley LI. Thoracic epidural in the management of chest trauma: a study of 161 cases. Intensive Care Med 1985;11:312–315.
27. Ilahi OA, Davidson JP, Tullos HS. Continuous epidural analgesia using fentanyl and bupivacaine after total knee arthroplasty. Clin Orthop 1994;44–52.
28. Rygnestad T, Borchgrevink PC, Eide E. Postoperative epidural infusion of morphine and bupivacaine is safe on surgical wards: organization of the treatment, effects and side effects in 2000 consecutive patients. Acta Anaesthesiol Scand 1997;41:868–876.
29. Liu SS, Allen HW, Olsson GL. Patient-controlled epidural analgesia with bupivacaine and fentanyl on hospital wards: prospective experience with 1,030 surgical patients. Anesthesiology 1998;88:688–695.
30. Curatolo M, Kaufmann R, Petersen-Felix S, Arendt-Nielsen L, Scaramozzino P, Zbinden AM. Block of pinprick and cold sensation poorly correlate with relief of postoperative pain during epidural analgesia. Clin J Pain 1999;15:6–12.
31. Krames ES, Lanning RM. Intrathecal infusional analgesia for nonmalignant pain. analgesic efficacy of intrathecal opioid with or without bupivacaine. J Pain Symptom Manage 1993;8:539–548.
32. Sjoberg M, Nitescu P, Appelgren L, Curelaru I. Long-term intrathecal morphine and bupivacaine in patients with refractory cancer pain. results from a morphine/bupivacaine dose regimen of 0.5: 4.75 mg/ ml. Anesthesiology 1994;80:284–297.
33. Dahm P, Nitescu P, Appelgren L, Curelaru I. Efficacy and technical complications of long-term continuous intraspinal infusions of opioid and/or bupivacaine in refractory nonmalignant pain: a comparison between the epidural and the intrathecal approach with externalized or implanted catheters and infusion pumps. Clin J Pain 1998;14:4–16.
34. Appelgren L, Nordborg C, Sjoberg M, Karlsson PA, Nitescu P, Curelaru I. Spinal epidural metastasis: implications for spinal analgesia to treat ‘refractory’ cancer pain. J Pain Symptom Manage 1997;13:25–42.
2. Desai S, Lim Y, Tan CH, Sia AT. A randomised controlled trial of hyperbaric bupivacaine with opioids, injected as either a mixture or sequentially, for spinal anaesthesia for caesarean section. Anaesth Intensive Care. 2010;38:280–4.
3. Belzarena SD. Clinical effects of intrathecally administered fentanyl in patients undergoing cesarean section. Anesth Analg. 1992;74:653–7.
4. Burns SM, Cowan CM, Wilkes RG. Prevention and management of hypotension during spinal anaesthesia for elective Caesarean section: a survey of practice. Anaesthesia 2001; 56: 794—8
5. Choi DH, Ahn HJ, Kim MH. Bupivacaine-sparing effect of fentanyl in spinal anesthesia for cesarean delivery. Reg Anesth Pain Med 2000; 25: 240—5.
6. Elia N, Culebras X, Mazza C, Schiffer E, Tramèr MR. Clonidine as an adjuvant to intrathecal local anesthetics for surgery: Systematic review of randomized trials. Reg Anesth Pain Med. 2008;33:159–67.
7. Wang JK, Nauss LA, Thomas JE. Pain relief by intrathecally applied morphine in man. Anesthesiology. 1979;50:149–51.
8. Selvaraju KN, Sharma SV. Comparison of forced expiratory spirometric flow changes following intrathecal bupivacaine and bupivacaine with fentanyl. South Afr J Anesth Analg. 2008;14:33–7.
9. De Kock M. Site of hemodynamic effects of alpha 2-adrenergic agonists. Anesthesiology. 1991;75:715–6.
10. Bonnet F, Buisson VB, Francois Y, Catoire P, Saada M. Effects of oral and subarachnoid clonidine on spinal anesthesia with bupivacaine. Reg Anesth. 1990;15:211–4.
11. Sethi BS, Samuel M, Sreevastava D. Efficacy of analgesic effects of low dose intrathecal clonidine as adjuvant to bupivacaine. Indian J Anaesth. 2007;51:415–9.
12. Siddik-Sayyid SM, Aouad MT, Jalbout MI et al. Intrathecal versus intravenous fentanyl for supplementation of subarachnoid block during cesarean delivery. Anesth Analg 2002; 95: 209—13.
13. Shende D, Cooper GM, Bowden MI. The influence of intrathecal fentanyl on the characteristics of subarachnoid block for caesarean section. Anaesthesia 1998; 53: 706—10.
14. Cowan CM, Kendall JB, Barclay PM, Wilkes RG. Comparison of intrathecal fentanyl and diamorphine in addition to bupivacaine for caesarean section under spinal anaesthesia. Br J Anaesth 2002; 89: 452—8.
15. Hildebrand K, Elsberry D, Deer T. Stability, compatibility and safety of intrathecal bupivacaine administered chronically via an implantable delivery system. Clin J Pain in press.
16. Trissel LA. Handbook on Injectable Drugs, 10th edn. Bethesda: American Society of Health-System Pharmacists, Inc, 1998.
17. Keera AA, Elnabtity AM. Two syringe spinal anesthesia technique for cesarean section: a controlled randomized study of a simple way to achieve more satisfactory block and less hypotension. Anesth Essays Res. 2016;10:312–8.
18. Breen TW, Shapiro T, Glass B, Foster-Payne D, Oriol NE. Epidural anesthesia for labor in an ambulatory patient. Anesth Analg. 1993;77:919–24.
19. Agrawal A, Agrawal S, Asthana V, Payal YS, Sharma J, Gupta V. Comparison of intrathecal fentanyl and sufentanil in addition to bupivacaine for caesarean section under spinal anaesthesia. J Anaesth Clin Pharmacol. 2009;25:154–6.
20. Shidhaye RV, Shah BB, Joshi SS, Deogaonkar SG, Bhuva AP. Comparison of clonidine and fentanyl as an adjuvant to intrathecal bupivacaine for spinal anaesthesia and postoperative analgesia in patients undergoing caesarian section. Sri Lankan J Anaesthesiol. 2013;22:15–20.
21. Shah BB, Shidhaye RV, Divekar DS, Panditrao M, Panditrao MM, Suryawanshi C. Effect of addition of clonidine to bupivacaine used for patients undergoing spinal anaesthesia: A randomized, double blind, controlled study. Sri Lankan J Anaesthesiol. 2011;19:17–21.
22. Kothari N, Bogra J, Chaudhary AK. Evaluation of analgesic effects of intrathecal clonidine along with bupivacaine in cesarean section. Saudi J Anaesth. 2011;5:31–5.
23. Bajwa SJ, Bajwa SK, Kaur J, Singh A, Singh A, Parmar SS. Prevention of hypotension and prolongation of postoperative analgesia in emergency cesarean sections: A randomized study with intrathecal clonidine. Int J Crit Illn Inj Sci. 2012;2:63–9.
24. Biswas BN, Rudra A, Bose BK, Nath S, Chakrabarty S, Bhattacharjee S. Intrathecal fentanyl with hyperbaric bupivacaine improves analgesia during caesarean delivery and in early post operative period. Indian J Anaesth. 2002;46:469–72.
25. Kanayama N, Belayet HM, Khatun S et al. A new treatment of severe pre-eclampsia by long-term epidural anaesthesia. J Hum Hypertens 1999;13:167–171.
26. Worthley LI. Thoracic epidural in the management of chest trauma: a study of 161 cases. Intensive Care Med 1985;11:312–315.
27. Ilahi OA, Davidson JP, Tullos HS. Continuous epidural analgesia using fentanyl and bupivacaine after total knee arthroplasty. Clin Orthop 1994;44–52.
28. Rygnestad T, Borchgrevink PC, Eide E. Postoperative epidural infusion of morphine and bupivacaine is safe on surgical wards: organization of the treatment, effects and side effects in 2000 consecutive patients. Acta Anaesthesiol Scand 1997;41:868–876.
29. Liu SS, Allen HW, Olsson GL. Patient-controlled epidural analgesia with bupivacaine and fentanyl on hospital wards: prospective experience with 1,030 surgical patients. Anesthesiology 1998;88:688–695.
30. Curatolo M, Kaufmann R, Petersen-Felix S, Arendt-Nielsen L, Scaramozzino P, Zbinden AM. Block of pinprick and cold sensation poorly correlate with relief of postoperative pain during epidural analgesia. Clin J Pain 1999;15:6–12.
31. Krames ES, Lanning RM. Intrathecal infusional analgesia for nonmalignant pain. analgesic efficacy of intrathecal opioid with or without bupivacaine. J Pain Symptom Manage 1993;8:539–548.
32. Sjoberg M, Nitescu P, Appelgren L, Curelaru I. Long-term intrathecal morphine and bupivacaine in patients with refractory cancer pain. results from a morphine/bupivacaine dose regimen of 0.5: 4.75 mg/ ml. Anesthesiology 1994;80:284–297.
33. Dahm P, Nitescu P, Appelgren L, Curelaru I. Efficacy and technical complications of long-term continuous intraspinal infusions of opioid and/or bupivacaine in refractory nonmalignant pain: a comparison between the epidural and the intrathecal approach with externalized or implanted catheters and infusion pumps. Clin J Pain 1998;14:4–16.
34. Appelgren L, Nordborg C, Sjoberg M, Karlsson PA, Nitescu P, Curelaru I. Spinal epidural metastasis: implications for spinal analgesia to treat ‘refractory’ cancer pain. J Pain Symptom Manage 1997;13:25–42.