Two Syringe Technique for Spinal Anesthesia in Cesarean Section: A Study of a Simple Way to Achieve more Satisfactory Block, Less Frequency of Hypotension and Prolong Analgesia

Spinal anaethesia is now the safest and most popular method for cesarean section. Hypotension is common adverse effect of spinal anaethesia. Fentanyl added to bupivacaine enhances the sensory blockage without altering the degree of sympathetic blockade and less significant adverse effect. The reason might be that the mixture of hyperbaric bupivacaine and fentanyl may alter the density of hyperbaric bupivacaine solutions and affect the spread of drugs. So this study is undertaken to find out if the effect of these two drugs can vary by altering their technique of administration. This observational study compared the effect of spinal injection of hyperbaric bupivacaine and fentanyl in separate syringe with standard injection of mixed fentanyl with hyperbaric bupivacaine. . Total 60 patients are equally divided into two groups Group M 25ug fentanyl (0.5cc) premixed with 0.5 % bupivacaine heavy 10 mg (2cc) in the same syringe. Group S 25ug fentanyl (0.5cc) and 0.5 %bupivacaine heavy 10 mg (2cc) separate syringes. We concluded that Separate intrathecal injections of Fentanyl and hyperbaric bupivacaine provided significant improvement in the quality of sensory block with reduction in frequency of hypotension compared to injection of mixed medication.