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Subject Area

Anesthesiology

Article Type

Original Study

Abstract

Objectives To measure the perioperative fetal and maternal outcomes and the postoperative analgesic effects when using intrathecal nalbuphine as an adjuvant to bupivacaine and intrathecal adenosine as an adjuvant to bupivacaine controlled by fentanyl as an adjuvant to bupivacaine during spinal anesthesia for elective cesarean section. Background Spinal anesthesia for cesarean delivery is the best anesthetic technique as it is simple to perform with rapid onset of anesthesia and complete muscle relaxation. Lower incidence of failed block, less drug doses, minimal neonatal depression, and decreased incidence of aspiration pneumonitis are added advantages of spinal anesthesia. Patients and methods After obtaining approval from the ethical committee for our study, patients admitted to El Menoufia University Hospital for cesarean delivery were enrolled in this study. We calculated that the minimum proper sample size was 25 patients in each group to be able to reject the null hypothesis with 80% power at α=0.05 level using one-way analysis of variance test. Results Level of sensory block was assessed using loss of cold discrimination (ice test) and motor block (assessed by Bromage scale: 0 = none, 1 = just able to move the knee but not the hip, 2 = able to move the foot only, and 3 = unable to move the knee or foot). All patients included in the study had sensory level from T4 to S5. Conclusion Nalbuphine showed better maternal and fetal outcomes than adenosine in spinal anesthesia for elective cesarean section as an adjuvent to bupivacaine intrathecally and in comparison with fentanyl.

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