Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Effect of bupivacaine combined with fentanyl for simultaneous spinal-epidural anesthesia on hemodynamics, and maternal and infant outcomes in patients undergoing cesarean section

Shuai Li^1-3, Xiao Dai^2-4, Ying Wang⁵, Lei Shen⁶, Nannan Hao^1-3

¹Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou, Jiangsu; ²The Affiliated Xuzhou Central Hospital of Nanjing University of Chinese Medicine; ³Xuzhou Clinical School of Xuzhou Medical University; ⁴Operating Theatre, Xuzhou Central Hospital, Xuzhou, Jiangsu; ⁵Department of Anesthesiology, The Affiliated Yanda Hospital of Heibei Medical University, Langfang, Hebei; ⁶Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.

For correspondence:- Nannan Hao Email: paperworkdan@163.com Tel:+8618168778159

Accepted: 14 December 2021 Published: 31 January 2022

Citation: Li S, Dai X, Wang Y, Shen L, Hao N. Effect of bupivacaine combined with fentanyl for simultaneous spinal-epidural anesthesia on hemodynamics, and maternal and infant outcomes in patients undergoing cesarean section. Trop J Pharm Res 2022; 21(1):193-199 doi: 10.4314/tjpr.v21i1.28

© 2022 The authors.
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Abstract

Purpose: To compare the effects of bupivacaine combined with fentanyl vs. bupivacaine alone in cesarean patients undergoing combined spinal-epidural anesthesia (CSE).

Methods: This was a randomized controlled study that included 84 healthy women with singleton foetuses who were scheduled for cesarean delivery at Xuzhou Central hospital. They were divided into fentanyl combined with bupivacaine group (group A, n = 42) and bupivacaine alone group (Group B, n = 42). The primary outcome was hemodynamic changes in patients undergoing cesarean section while the secondary outcomes were neonatal Apgar score, incidence of intraoperative and postoperative adverse reactions and time to onset, and duration of anesthesia.

Results: One hour after the surgery started, blood pressure was significantly lower in group A than in group B. Upon skin incision and one hour after commencement, the group A showed decreased heart rate compared with group B. Intraoperative pain level was significantly lower in group B than in group A. Compared with group A, group B has shorter motor block time, and duration of motor block was significantly longer in group B than in group A.

Conclusion: Bupivacaine combined with fentanyl improves maternal hemodynamic stability during cesarean section, resulting in faster onset of anesthesia and prolonged motor block, but with no difference from bupivacaine alone in terms of intraoperative and intraoperative adverse reactions, neonatal cardiopulmonary and circulatory function.

Keywords: Bupivacaine, Fentanyl, Cesarean section, Spinal-epidural anesthesia