A Comparative Study between Bupivacaine (S75-R25) and Ropivacaine in Spinal Anesthesia for Labor Analgesia

Nogueira, Celso Schmalfuss; Lima, Luciana Cavalcanti; Paris, Valter César; Neiva, Priscila Milhomem; Otani, Erica Tanaka; Couceiro, Roberto de Oliveira; Burim, Fabio; Ferreira, Jonas Antônio Franco; Cadecaro, Patrícia

doi:10.1016/s0034-7094(10)70060-x

Cited by 5 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are three general determinants of blood pressure: intravascular volume status, cardiac output, and systemic vascular resistance (SVR) (generally determined by sympathetic activity) (6). SA-induced sympathetic denervation causes the reduction of SVR, which leads to relative hypovolemia (2,3). We failed to find statistically significant differences in changes of IVC in , IVC ex , and IVC-CI between the hypotensive and non-hypotensive patients after the intervention.…”

Section: Discussionmentioning

confidence: 68%

See 1 more Smart Citation

Can the inferior vena cava collapsibility index be useful in predicting hypotension during spinal anaesthesia in a spontaneously breathing patient? A mini fluid challenge

Jaremko

Mačiulienė

Gelmanas

et al. 2019

AML

View full text Add to dashboard Cite

The study was performed at the Department of Orthopaedics and Traumatology of the Kauno Klinikos Hospital of Lithuanian University of Health Sciences. Background. Intravascular fluids are empirically administered to prevent hypotension induced by spinal anaesthesia. Ultrasound measurements of the inferior vena cava (IVC) and the IVC collapsibility index (IVC-CI) is a non-invasive method to evaluate the intravascular volume status. The aim of the study was to identify the prognostic value of the IVC collapsibility index in spontaneously breathing patients to predict severe intraoperative hypotension. Materials and methods. Sixty patients undergoing elective knee arthroplasty under spinal anaesthesia were included in the prospective study. The diameters of IVCex, IVCin, and IVC-CI were measured before and 15 min after spinal anaesthesia when administration of 500 ml of normal saline using infusion pump was finished. The haemodynamic parameters (heart rate, systolic, diastolic, and mean blood pressures, breathing rate) were collected. Results. Severe arterial hypotension was noticed in 18.3% of the patients. No statistically significant differences were detected between changes in IVCex, IVCin, and IVC-CI comparing hypotensive and non-hypotensive patients at the baseline and after the interventions (p > 0.005). According to receiver operating characteristic (ROC) analysis, IVC-CI is not effective in the prediction of severe hypotension during spinal anaesthesia in spontaneously breathing patients: the area under the ROC curve for IVC-CI was 0.05. Conclusions. IVC-CI is not an effective predictor of severe hypotension after induction of spinal anaesthesia followed by normal saline administration in spontaneously breathing patients undergoing elective knee arthroplasty. More trials, including different patient subgroups, will be needed.

show abstract

Section: Discussionmentioning

confidence: 68%

“…During the SA, sympathetic fibres are blocked and, as a result, sympathetic denervation is caused. Hypotension during SA can be caused by decreased heart preload or reduced systemic vascular resistance (relative hypovolemia) (2,3).…”

Section: Introductionmentioning

confidence: 99%

Can the inferior vena cava collapsibility index be useful in predicting hypotension during spinal anaesthesia in a spontaneously breathing patient? A mini fluid challenge

Jaremko

Mačiulienė

Gelmanas

et al. 2019

AML

View full text Add to dashboard Cite

show abstract

“… 18 Various studies have investigated separately the efficacy of bupivacaine and ropivacaine as local anesthetics for regional block alone or with adjuvants such as fentanyl or dexmedetomidine. 19 20 But so far, no comparative study, like the recent one, has been reported. Hence, this study was designed to compare the onset and duration of axillary block with 0.5% ropivacaine plus either dexmedetomidine, fentanyl, or verapamil in forearm surgeries.…”

Section: Introductionmentioning

confidence: 94%

Effects of adding dexmedetomidine, fentanyl, and verapamil to 0.5% ropivacaine on onset and duration of sensory and motor block in forearm surgeries: a randomized controlled trial

et al. 2021

View full text Add to dashboard Cite

This study was aimed to compare the onset and duration of axillary block with ropivacaine 0.5% plus either dexmedetomidine, fentanyl, or verapamil in forearm surgeries. This double-blind clinical trial enrolled three equal-sized block-randomized groups of patients ( n = 105) scheduled for hand and forearm surgery at Arak, Iran in 2019, who received: (i) ropivacaine (40 mL/0.5%) + dexmedetomidine (1 μg/kg), (ii) ropivacaine (40 mL/0.5%) + fentanyl (1 μg/kg), and (iii) ropivacaine (40 mL/0.5%) + verapamil (2.5 mg), respectively. We recorded some vital signs such as mean arterial pressure, heart rate and oxygen saturation, onset of complete sensory and motor block, duration of the block, opioid use, as well as pain score at recovery and certain time points (2, 4, 6, 12, and 24 hours post-operation). Adding dexmedetomidine to ropivacaine (40 mL/0.5%) prolonged the duration of sensory ( P = 0.001) and motor block ( P = 0.001) in compared to adding fentanyl and verapamil and it also shortens the time to onset of sensory ( P = 0.001) and motor block ( P = 0.001). There is a significant difference between three groups in terms of visual analog scale mean and the lowest pain score was obtained in the dexmedetomidine group ( P = 0.001), significant time trend ( P = 0.001), as well as the time and groups interaction ( P = 0.001). Dexmedetomidine was concluded to be associated with alleviated pain; reduced opioid use; short onset of sensory block; and prolonged duration of sensory and motor block. It hence is recommended to lengthen the duration of axillary block and to help relieve postoperative pain and ultimately to move to cut down the postoperative opioid use in forearm surgery. The study was approved by the Ethical Committee of Arak University of Medical Sciences (approval No. IR.ARAKMU. REC.1397.266), and registered on Iranian Registry of Clinical Trials (registration No. IRCT20141209020258N111) on May 9, 2019.

show abstract

“…Spinal anaesthesia is an ubiquitous clinical practice, its most feared and common side effect consisting of an abrupt reduction of systemic vascular resistances and a consequent risk of systemic hypotension [1] , [2] , [3] . To prevent this complication, an adequate correction of patients’ volume status is often obtained through a preventive fluids administration [4] , [5] , [6] , [7] .…”

Section: Introductionmentioning

confidence: 99%

PROtocolized care to reduce HYpotension after spinal anaesthesia (ProCRHYSA randomized trial): Study protocol for a randomized controlled trial

Ceruti

Minotti

Vivo

et al. 2016

Contemporary Clinical Trials Communications

View full text Add to dashboard Cite

BackgroundThe PROtocolized Care to Reduce HYpotension after Spinal Anaesthesia (ProCRHYSA trial) is an unblinded, randomized, monocentric, prospective, three-arm, parallel-group trial aimed at assessing the role of a controlled volemic repletion in reducing both clinically significant hypotension rate and total amount of fluid administered in patients undergoing spinal anaesthesia.Methods/DesignAim of the study is assessing the effectiveness of a non-invasive tests to guide a titrated volemic repletion before spinal anesthesia in order to reduce post-spinal hypotension rate. After local ethical committee approval of the study (Comitato Etico Cantonale Ref. N. CE2796), we will randomize patients undergoing elective surgery under spinal anesthesia into two parallel groups: in the first vena cava ultrasound will be used in order to assess adequacy of patients’ volemic status and consequently guide the administration of crystalloids boluses; in the second passive legs raising test will be used instead of ultrasound for the same purpose.DiscussionThe hypothesis we want to test is that the using of these two experimental methods before spinal anaesthesia, compared to the standard method (empirical fluid administration) can reduce the impact of systemic hypotension through an adequate titrated volemic repletion, avoiding both hypotension and fluid overload. The final purpose is to ensure that spinal anaesthesia is performed in the safest way possible.ConclusionsThe study will offer a new insight on the possible role of vena cava ultrasound and passive legs raising test as screening tools to prevent hypotension after spinal anesthesia. These tests were already validated in a critical environment, but to the best of our knowledge this is the first time they are applied to an elective surgical population.Trial registrationThe trial was registered on May 2014 on www.clinicalstrial.gov with the number NCT02070276.

show abstract

A Comparative Study between Bupivacaine (S75-R25) and Ropivacaine in Spinal Anesthesia for Labor Analgesia

Abstract: The use of bupivacaine (S75-R25) and ropivacaine in labor analgesia provided good conditions for spinal anesthesia with small indices of adverse events.

Cited by 5 publications

References 27 publications

Can the inferior vena cava collapsibility index be useful in predicting hypotension during spinal anaesthesia in a spontaneously breathing patient? A mini fluid challenge

Can the inferior vena cava collapsibility index be useful in predicting hypotension during spinal anaesthesia in a spontaneously breathing patient? A mini fluid challenge

Effects of adding dexmedetomidine, fentanyl, and verapamil to 0.5% ropivacaine on onset and duration of sensory and motor block in forearm surgeries: a randomized controlled trial

PROtocolized care to reduce HYpotension after spinal anaesthesia (ProCRHYSA randomized trial): Study protocol for a randomized controlled trial

Contact Info

Product

Resources

About