Comparison of bupivacaine with fentanyl and bupivacaine with fentanyl and adrenaline in epidural

Studies have shown that adrenaline when added to epidural anesthesia with bupivacaine in thoracic epidural has caused an increase in duration of anesthesia and increased in motor block intensity. It was found that when used in labour analgesia was found to be disadvantageous, as motor block was more when used in combination with bupivacaine. This was hypothesized to be because of vasoconstriction caused by adrenaline and also by alpha 2 agonism. Hence our study was designed to find the effect of epidural adrenaline in combination with bupivacaine and fentanyl in epidural anesthesia. In our study we compared 40 patients who underwent elective orthopedic surgeries in supine position. 20 patients received 0.5 bupivacaine with 1 micro gram per ml fentanyl as compared to 20 who received 0.5 bupivacaine with 1 micro gram per ml fentanyl and 1 in 200000 adrenaline. The block onset, degree of motor block, duration of the anesthesia and hemodynamics in the two groups were compared and analyzed. And our study found out that addition of adrenaline in concentration of 1 in 200000 cause quicker onset of block, denser motor blockade, with no significant prolongation in duration of regression or post op analgesia.