Background- The pre-eclampsia patients may carry a high risk with use of spinal anesthesia owing to possibility of severe hypotension. Low dose of anaesthetic agent with adjuvant is safely use as a regional anesthesia in pre-eclampsia cases, and need of general anesthesia can be avoid, which is itself related to maternal and fetal complication.
Objective: To compare the effects of fentanyl and clonidine as adjunct to levobupivacaine, administered by intrathecal route in pre-eclampsia patients.
Methods: This was a prospective comparative study conducted on sixty pre-eclampsia parturient planned for emergency caesarean delivery under spinal anesthesia. Patients were divided into two groups: Group1- patients received 2 ml of 0.5 % isobaric levobupivacaine (10 mg) plus 25 microgram fentanyl and Group 2 patients received 2 ml of 0.5 % isobaric levobupivacaine plus 30 microgram clonidine. The vital events and outcome measures were recorded.
Results: The mean HR was lower in group 2 as compared to group1. Blood pressure (SBP, DP, MAP) was higher in group 2 as compared to group 1 at different interval. The mean onset time of group 2 (136.63 ± 25.97 sec.) was significantly lower as compared to group 1 (174.90 ± 27.58 sec.). The time to bromage score 3 was found to be significantly lower in group 2 than group1. The time to achieve maximum sensory level was significantly lower in group 2 than group 1. Two segment regression times was significantly higher (75.53 ± 6.13 min) in group 2 as compared to group 1(66.67 ± 8.74 min). There was no significant difference in the APGAR score in two groups.
Conclusion: It is concluded that spinal anesthesia with isobaric levobupivacaine with clonidine provides fast and effective induction of surgical anesthesia for emergency cesarean section with minimal hemodynamic instability.
Impact Factor
2017: 6.614
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