Comparison of analgesic efficacy of intrathecal 1% 2-chloroprocaine with or without fentanyl in elective caesarean section: A prospective, double-blind, randomised study

Abstract

Background and Aims: Preservative free 1% 2-chlorprocaine is a short acting local anaesthetic agent suitable for day care surgical procedures. Potentiation of analgesic action of intrathecal local anaesthetics by the addition of opioids is well known. In this study, we investigated the effect of intrathecal fentanyl as an adjuvant to 1% 2-chloroprocaine (2-CP) in parturients undergoing elective lower segment caesarean section (LSCS). Methods: This prospective randomised comparative study was performed on 150 healthy, term parturients planned for elective low risk LSCS, divided into two equal groups. The group CS received 1% preservative-free 2-CP 3 ml (30 mg) + 0.5 ml normal saline and group CF received 1% preservative-free 2-CP 3 ml (30 mg) + 0.5 ml fentanyl (25 μg) with a total volume of 3.5 ml intrathecally in both groups. The duration of sensory blockade, duration of motor blockade, maximum height of sensory block, haemodynamic parameters, quality of block, neonatal outcome, patient satisfaction and any side effects were recorded. Results: There were no significant differences in demographic characteristics, haemodynamic parameters, onset of sensory block, onset of motor block and duration of motor block between the groups. The duration of sensory block and duration of analgesia was statistically prolonged in group CF than group CS (P value < 0.0001). There was no statistical difference in the Apgar score of newborns in both groups. The adverse effects (hypotension, bradycardia, nausea/vomiting, shivering and transient neurological symptoms) were comparable in both the groups. Conclusion: The addition of fentanyl to 1% 2-chloroprocaine intrathecally prolonged the duration of sensory block and postoperative analgesia in patients undergoing LSCS.