Minimal Local Analgesic Dose of Intrathecal Bupivacaine and Ropivacaine in Patients Undergoing Cesarean Section: A Comparative Study (original) (raw)
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Comparative Evaluation of Different Dose of Bupivacaine for Pain Control in Cesarean Section
Academia Anesthesiologica International, 2019
Background: Spinal anesthesia is the preferred choice of anesthesia for the conduct of emergency and elective cesarean section. Hypotension during spinal anesthesia for caesarean section continues to be a major problem. Aim: The present study investigated the safety and efficacy of 0.25% hyperbaric bupivacaine on the incidence of visceral pain during cesarean section performed under subarachnoid anesthesia. Subjects and Methods: Sixty patients who were scheduled for elective cesarean section, allocated randomly to one of three groups, according to patient`s height. Group 1, 2 and 3 received 3.2-3.6 mL (8-9 mg), 3.6-4.0 mL (9-10 mg) and 4.0-4.4 mL (10-11 mg) of 0.25% hyperbaric bupivacaine, respectively. Results: There was no difference in the incidence of visceral pain between three groups (p>0.05), but the quality of intraoperative analgesia, as needs for general anesthesia was significantly lower in group 3 than groups 1 and 2 (p<0.05). Conclusion: In conclusion, hyperbaric 0.25% bupivacaine in the dose of 10-11 mg is safe and effective in obtaining better quality of block in cesarean section, in order of reducing the severity of visceral pain.
Anesthesiology and Pain Medicine
Background: Decreasing side effects and improving the quality of block in caesarean sections by appropriate dosage of local anesthetics and adjuvants could play an important role in the safe management of cesarean section. The present study aimed at comparing the effects of 3 different doses of intrathecal hyperbaric bupivacaine injected with a fixed dose of sufentanil in cesarean sections. Methods: In a double-blind randomized clinical trial, 105 candidates of elective cesarean section were randomly assigned into 3 groups of 8, 9, and 10 mg of intrathecal bupivacaine plus sufentanil 2.5 µg. The maximum level of sensory block, the intensity of motor block, and vital signs were measured at regular intervals. The incidence of hypotension and bradycardia were also recorded. Results: No significant difference was found between the maximum level of sensory block and the intensity of motor block in 3 groups. The incidences of hypotension and bradycardia as well as administration of atropine and ephedrine were comparable among the 3 groups (P > 0.05). Conclusions: According to similar effects of different doses of bupivacaine, administration of lower doses of bupivacaine (8mg) is more reasonable for spinal anesthesia for cesarean section.
Comparison of intrathecal bupivacaine, levobupivacaine for cesarean section
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2014
BACKGROUND Some investigators found a greater incidence of hypotension in patients receiving intrathecal hyperbaric solution than in patients receiving plain solution for cesarean section. OBJECTIVE Compare the effects of intrathecal hyperbaric bupivacaine 10 mg with intrathecal bupivacaine 11 mg and intrathecal levobupivacaine 11 mg, all with 10 microg of fentanyl, for cesarean section. MATERIAL AND METHOD This prospective, randomized, double-blinded study was approved by the Ethics Committee. Ninety ASA I-II parturients undergoing elective cesarean section were enrolled. Group H received 10 mg of 0.5% hyperbaric bupivacaine plus fentanyl 10 g, Group B received 11 mg of 0.5% bupivacaine plus fentanyl 10 g, and Group L received 11 mg of 0.5% levobupivacaine plus fentanyl 10 g. Spinal anesthesia (SA) was undertaken in right lateral position and spinal solutions were injected approximately 30 to 40 seconds. Sensory and motor block were assessed at 5-minute intervals. Side-effects such...
Comparative Study of Intrathecal Bupivacaine versus Bupivacaine with Fentanyl for Cesarean Section
Innovative publication, 2016
Background: Spinal anaesthesia for cesarean section has been the preferred technique for majority of anaesthesiologist. Maternal hypotension following spinal anaesthesia remains common place in cesarean delivery. The combination of reduced dose of local anaesthetics with intrathecal opioids makes it possible to achieve adequate spinal anaesthesia with minimum hypotension. Objectives: The aim of our study was to compare the effectiveness of plain bupivacaine with low dose bupivacaine plus fentanyl with respect to sensory and motor blockade, hemodynamic changes, side effect profile and post-operative analgesia after spinal anaesthesia. Material and methods: 60 patients undergoing elective cesarean section under spinal anaesthesia were randomly allocated to two equal groups; Group B patients received 10 mg (2 mL) of 0.5% hyperbaric bupivacaine and Group B + F received 8mg (1.6 mL) of 0.5% hyperbaric bupivacaine plus 20 ug (0.4 mL) preservative free fentanyl. The clinical profile of subarachnoid block in two groups and its effect on maternal and neonatal outcome was studied. Results: The mean time required to reach peak sensory level was earlier in Group B + F. Mean time of two segment regression of sensory analgesia and complete sensory recovery was significantly earlier in Group B. Duration of motor recovery was earlier in Group B +F. Mean maximal heart rate was significantly more in Group B. Mean minimal systolic arterial pressure was significantly less in Group B compared to Group B + F. The duration of effective analgesia was significantly more in Group B + F (235.33+29.15) compared to Group B (120.33+10.98). The incidence of side effects was less in Group B + F than Group B. Conclusion: We can conclude that the addition of low dose fentanyl to 0.5% hyperbaric bupivacaine for spinal anaesthesia in cesarean section provides satisfactory sensory and motor blockade, better hemodynamic stability, less side effects and effective post-operative analgesia.
Journal of Drug Delivery and Therapeutics, 2020
Objective: Evaluation of the hemodynamic, respiratory and fetal side effects of two protocols for spinal anesthesia (P1: bupivacaine-fentanyl; P2: ropivacaine-fentanyl). Material and Method: Prospective pseudo-randomized study comparing two spinal anesthesia protocols for emergency cesarean section conducted in the operating room of the regional hospital center of Saint Louis in Senegal. Study duration was 4 months. We studied, age, indication for Caesarean section, medical and surgical history, P1 and P2 protocols, hypotension, bradycardia, Apgar scores at birth and at 5min. Univariate and bivariate analysis was performed on the R software. Result: A total of 115 patients were collected, with a mean age of 27.1 years (E: 15 - 45) and a standard deviation of 7.6. Indications for Caesarean section were maternal and fetal dystocia for 67 patients (58%), fetal distress for 39 parturients (34%), and pre-eclampsia for 5 patients (4%). The P1-Bupi spinal protocol was used in 42 patients (...
Spinal anaesthesia for cesarean section with reduced dose of intrathecal bupivacaine plus fentanyl
Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences, 2006
The hypotension following spinal anesthesia remains common place in cesarean delivery. The combination of reduced dose of local anesthetics with intrathecal opioids makes it possible to achieve adequate spinal anesthesia with minimum hypotension. We investigate whether this synergistic phenomenon could be used to provide less frequent hypotension while incurring adequate spinal anesthesia for cesarean section. Forty women scheduled for cesarean delivery (twenty in each group) were divided into two groups of patients who received a spinal injection of either 13.5 mg of standardized isobaric 0.5% bupivacaine or 9 mg of isobaric bupivacaine with 20 microgr fentanyl added. Each measurement of a systolic blood pressure less than 95 mm Hg or a decrease in systolic pressure of greater than 25% from baseline was considered as hypotension and treated with a bolus of 5 to 10 mg of intravenous ephedrine. The quality of surgical anesthesia was evaluated also. Spinal block provided excellent sur...
The ED50 and ED95 of Intrathecal Isobaric Bupivacaine with Opioids for Cesarean Delivery
Anesthesiology, 2005
The ideal intrathecal isobaric bupivacaine dose for cesarean delivery anesthesia is uncertain. While small doses (5-9 mg) of bupivacaine may reduce side effects such as hypotension, they potentially increase spinal anesthetic failures. This study determined the ED 50 and ED 95 of intrathecal isobaric bupivacaine (with adjuvant opioids) for cesarean delivery.
Indian journal of applied research, 2018
Introduction: In this study we compared the effects of fractionated versus bolus dose of local anaesthetics in spinal anaesthesia for hemodynamic stability, characteristic of sensory and motor block and duration of analgesia in preeclamptic parturients. Methods: 60 patients were divided into two groups (30 in each). Group B patients received bolus dose of local anaesthetics, while group F patients received fractionated dose of local anaesthetics. Characteristic of sensory and motor block, duration of analgesia and hemodynamic stability were compared. Result: All the patients were haemodynamically stable in Group F as compared to Group B. Duration of sensory and motor block and duration of analgesia were longer in Group F as compared to Group B. Conclusion: Fractionated dose of spinal anaesthesia provides dense block, greater haemodynamic stability, and longer duration of analgesia as compared to bolus dose.