1 Department Of Anesthesiology, Shalamar Hospital, Lahore.
Corresponding Author: Dr. Qurat Ul Ain, Email: anniewaqas8448@gmail.com
Background: Maternal hypotension remains a common and clinically significant complication of spinal anaesthesia for cesarean delivery. The addition of intrathecal fentanyl to bupivacaine may enhance analgesia and influence hemodynamic stability; however, existing evidence remains inconsistent, particularly in low-resource settings.
Objective: To compare the effects of intrathecal bupivacaine alone versus bupivacaine combined with fentanyl on maternal hemodynamic parameters and perioperative outcomes during cesarean delivery.
Methods: This retrospective observational study was conducted at a tertiary care hospital in pakistan. Sixty-six asa ii parturients undergoing elective cesarean section under spinal anaesthesia were included and divided into two groups: bupivacaine alone (15 mg; n=33) and bupivacaine with fentanyl (12.5 mg + 15 µg; n=33). Hemodynamic parameters were recorded at baseline and at 2, 5, 10, and 15 minutes post-spinal injection. The primary outcome was incidence of hypotension. Secondary outcomes included vasopressor use, bradycardia, maternal side effects, and neonatal apgar scores. Data were analysed using repeated-measures anova and multivariable logistic regression.
Results: Baseline characteristics were comparable between groups. The combination group demonstrated significantly higher systolic blood pressure at all post-spinal time points (p < 0.01). The incidence of hypotension was significantly lower in the bupivacaine-fentanyl group compared to bupivacaine alone (18.2% vs 63.6%, p < 0.01). Vasopressor requirement was also reduced (18.2% vs 42.4%, p = 0.02). Multivariable analysis confirmed intrathecal fentanyl as an independent protective factor against hypotension (adjusted or = 0.28; 95% ci: 0.10–0.74; p = 0.01). Neonatal outcomes were comparable between groups. Pruritus was more frequent in the fentanyl group.
Conclusion: The addition of intrathecal fentanyl to bupivacaine was associated with improved maternal hemodynamic stability and reduced vasopressor requirement without adverse neonatal effects. These findings support the use of fentanyl as an adjuvant in obstetric spinal anaesthesia, although the influence of reduced local anaesthetic dose should be considered.
Keywords: Na
Source of support: Nil.
Conflict of interest: None
How To Cite This Article: Malik Qa, Waseem A, Bashir A, Babar H, Ahmed A, Kazmi I. Comparison Of Bupivacaine Alone Vs Bupivacaine With Fentanyl On Hemodynamic Changes During Spinal Anaesthesia In Obstetric Patients. Int J Drug Deliv Technol. 2026;16(21s):585. Doi: 10.25258/ijddt.16.21s.61