Comparison between morphine 0.1mg and fentanyl 20mcg for their duration of analgesia when administered intrathecaly in Caesarean Section (Synopsis)


Synopsis on Comparison between morphine 0.1mg and fentanyl 20mcg for their duration of analgesia when administered intrathecaly in Caesarean Section

Introduction / Background
The International association for the study of pain has defined pain as
Material and Methods
Very low dose of intrathecaly administered morphine still might probably result in longer duration of pain relief as compared to fentanyl through the same route but might cause lesser side effects.
Study Design : Interventional Study
Sample Size : 80 patients
Sampling Method : Randomized sampling technique will be adopted. Eighty cards will be prepared, and Fourty each will b
Duration of Study : two months
Inclusion Criteria
ASA class I-II, Parturient mothers coming to operation room for Lower segment Caesarean section.
Exclusion Criteria
patients with coagulopath, thrombocytopenia, shoch conditions, associated cardiac pathology, infected lumber area, history of obstructive sleep apnea, failure to attempt lumber puncture, patients pre medicated with any sedatives or opioids and refusal to join the study.
Data Collection Procedure
All the patients will be interviewed and complete pre operative systemic and laboratory assessment will be done. The nature, aims and objectives of the study will be explained and a written informed consent will be obtained from each patient. For all patients an IV line will be established and one liter of Lactated Ringer will be infused, and standard monitoring will be established with base line BP, Heart Rate, SPO2, ECG and Respiratory rate recorded.
Subaracnoid block will be performed at Lumber 3-4 or L4-5 using 27G whitacre spinal needle under sterile technique, upon successful lumber puncture the study drug will be injected along with 0.5% Heavy Bupivacain 10mg. And patient will be placed on the operating table in supine position with a wedge under right pelvis and table tilted five degree to the left side. Upon satisfactory anesthesia level is obtain surgery will be started. Injection time will be the starting point of the study. All the parameters will be recorded according to the proforma. Patient’s vital signs will be monitored and recorded during the surgery and in the recovery room till the motor block is weared off. Then patients will be transferred to the ward where the vital signs and pain assessment will be done hourly. Incidence of side effects will also be recorded. Time to analgesic demand will be recorded, and that will be the end point of our study. Side effects will be treated symptomatically as needed.
Statistical Methods
SPSS V.11 statistical computer soft wear will be used. For statistical analysis, the Student’s t test will be used to compare duration of analgesia, the primary aim of our study. Other continuous data (age, weight, lowest blood pressure incidence of itching and lowest respiratory rate) will also be analyzed by using the t test.
Similar Preliminary Studies
. Barkshire K, Russell R, Burry J, Popat M: A comparison of bupivacaine-fentanyl-morphine with bupivacaine-fentanyl- diamorphine for caesarean section under spinal anaesthesia.
Int J Obstet Anesth. 2001 Jan;10(1):4-10.

13. Muhammad Ishaque, Riaz Siddiqi, Shoaib Naiyar Hashmi, Azra Naseem, Ghulam Sabir,Mobeen Ikram:A study of post operative analgesia and adverse effects produced by intrathecal Neostigmine, Morphine and their combination in patients undergoing elective Cesarean Section under Spinal Anesthesia.Pak Armed Forces Med J Jun 2005;55(2):116-21.
14. Kristiina S. Kuusniemi,Kalevi K. Pihlajamäki, Mikko T. Pitkänen,Hans Y. Helenius, and Olli A. Kirvelä: The Use of Bupivacaine and Fentanyl for Spinal Anesthesia for Urologic Surgery. Anesth Analg 2000;91:1452-1456.


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