&lt;![CDATA[&lt;b&gt;Raquianestesia para cesariana&lt;/b&gt;: &lt;b&gt;estudo comparativo entre bupivaca?na isob?rica e hiperb?rica associadas ? morfina&lt;/b&gt;]]&gt;

Background: It has been suggested that morbidly obese parturients may require less local anesthetic for spinal anesthesia. The aim of this study was to determine the effective dose (ED 50 /ED 95 ) of intrathecal bupivacaine for cesarean delivery in morbidly obese patients. Methods: Morbidly obese parturients (body mass index equal to or more than 40) undergoing elective cesarean delivery were enrolled in this double-blinded study. Forty-two patients were randomly assigned to receive intrathecal hyperbaric bupivacaine in doses of 5, 6, 7, 8, 9, 10, or 11 mg (n ϭ 6 per group) coadministered with 200 g morphine and 10 g fentanyl. Success (induction) was defined as block height to pinprick equal to or more than T6 and success (operation) as success (induction) plus no requirement for epidural supplementation throughout surgery. The ED 50 /ED 95 values were determined using a logistic regression model. Results: ED 50 and ED 95 (with 95% confidence intervals) for success (operation) were 9.8 (8.6 -11.0) and 15.0 (10.0 -20.0), respectively, and were similar to corresponding values of a nonobese population determined previously using similar methodology. We were unable to measure ED 50 /ED 95 values for success (induction) because so few blocks failed initially, even at the low-dose range. There were no differences with regard to secondary outcomes (i.e., hypotension, vasopressor use, nausea, and vomiting). Conclusions: Obese and nonobese patients undergoing cesarean delivery do not appear to respond differently to mod-

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Spinal Anesthesia; Lower Segment Cesarean Section Comparison of Atients With Hyperbaric Bupivacaine Versus Isobaric Bupivacaine as Used for Spinal Anesthesia

Raza

Bourazza

Kamlaish

et al. 2016

TPMJ

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ABSTRACT… Objective: The purpose of the study is to compare and assess the sensory and motor block along with the associated hemodynamic changes that occur in the patient population operated for a lower segment cesarean section (LSCS), when they are given 0.5% hyperbaric bupivacaine versus 0.5% isobaric bupivacaine as used for spinal anesthesia. Study Design: Prospective double blind randomized trial. Period: 6 months duration from April 2014 to September 2014. Setting: A tertiary care hospital in the city of Karachi, Pakistan. Method: The study population consisted of 60 patients belonging to the ASA 1 and ASA 2 category, who underwent a lower segment cesarean section, and comparative analysis of the efficacy and associated hemodynamic changes of hyperbaric with isobaric bupivacaine. The patient population was segmented into two groups both groups containing 30 patients, group A receiving hyperbaric bupivacaine 0.5% as 2.5ml ( 12.5mg dose ) and the second group designated as, group B receiving isobaric bupivacaine 0.5% as 2.5ml ( 12.5mg dose) intrathecally. The resultant sensory and motor blockade was determined using pin prick and bromage scale respectively. Results: There was a significant difference found among the two groups under study, when compared at 3min interval regarding the sensory blockade. The level of T6 block was reached in 33.33% (n=10) patients belonging to group A and 56.66% (n= 17) patients in group B. It was observed that there was no significant change among the two groups at 5min interval regarding sensory and motor blockade respectively. The immediate sensory blockade with isobaric bupivacaine in group B produced greater decrease in the systolic and mean arterial blood pressure when contrasted with hyperbaric bupivacaine in group A at 5min interval, but after time interval of 45min there was no statistically significant change observed. Conclusions: According to our study the effects of isobaric bupivacaine were more significantly predictable; hence have a higher efficacy, when contrasted against hyperbaric bupivacaine in lower section cesarean section spinal anesthesia. Quick sensory blockade with isobaric bupivacaine was associated with more decrease in blood pressures when contrasted with the hyperbaric bupivacaine, but this result is not statistically significant. Key words:Lower segment cesarean section, Spinal anesthesia, hyperbaric bupivacaine, isobaric bupivacaine.

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<![CDATA[<b>Raquianestesia para cesariana</b>: <b>estudo comparativo entre bupivaca?na isob?rica e hiperb?rica associadas ? morfina</b>]]>

Abstract: JUSTIFICATIVA E OBJETIVOS:

Cited by 3 publications

References 7 publications

ED(50) and ED(95) of Intrathecal Bupivacaine in Morbidly Obese Patients Undergoing Cesarean Delivery

ED(50) and ED(95) of Intrathecal Bupivacaine in Morbidly Obese Patients Undergoing Cesarean Delivery

ED50and ED95of Intrathecal Bupivacaine in Morbidly Obese Patients Undergoing Cesarean Delivery

Spinal Anesthesia; Lower Segment Cesarean Section Comparison of Atients With Hyperbaric Bupivacaine Versus Isobaric Bupivacaine as Used for Spinal Anesthesia

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