Spinal Anesthesia for Cesarean Section. Use of Hyperbaric Bupivacaine (10mg) Combined with Different Adjuvants

Braga, Ana Luíza Mattos; Frias, José Aristeu Fachini; Braga, Franklin Sarmento da Silva; Potério, Glória Braga; Hirata, Eunice Sizue; Torres, Nathalia Agostini

doi:10.1016/s0034-7094(12)70178-2

Cited by 28 publications

(35 citation statements)

References 25 publications

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“…Studies have described incidence rates of pruritus reaching 62%, 67% and 80% with intrathecal morphine, fentanyl and sufentanil, respectively 28,29 . In agreement with other studies 8,9,28,29 , pruritus was the most common side-effect found in our study. However, there was no difference between both opioids.…”

Section: Discussionsupporting

confidence: 94%

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Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Randomized controlled study

Braga

Hirata

et al. 2014

Acta Cir. Bras.

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PURPOSE:To evaluate the efficacy and side-effects of fentanyl and sufentanil combined with hyperbaric spinal bupivacaine in elective cesarean section. METHODS:A prospective, randomized, double-blind study with 64 term parturients, distributed into 2 groups according to the opioid combined with hyperbaric bupivacaine 0.5% (10mg): GF -fentanyl (25µg) and GS -sufentanil (5.0µg). The latency and maximum sensory block level; degree and duration of motor block; duration and quality of analgesia; maternal-fetal repercussions were evaluated.This was an intention-to-treat analysis with a 5% significance level. RESULTS:The latency period, maximum sensory block level, motor block degree and perioperative analgesia were similar in both groups. Motor block and analgesia had a longer duration in the sufentanil group. Maternal adverse effects and neonatal repercussions were similar. The incidence of hypotension was higher in the fentanyl group. In both groups, there was a predominance of patients who were awake and either calm or sleepy. CONCLUSIONS:The addition of fentanyl and sufentanil to hyperbaric subarachnoid bupivacaine was shown to be effective for the performance of cesarean section, and safe for the mother and fetus. Analgesia was more prolonged with sufentanil.Key words: Anesthetics. Combined Subarachnoid Space. Analgesics, Opioid. Fentanyl, Sufentanil. Anesthetics, Local. Bupivacaine. Cesarean Section.Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section.

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Section: Discussionsupporting

confidence: 94%

“…Furthermore, there is a decrease in local anesthetic dose, minimizing the risk of maternal arterial hypotension and damage to the fetus [2][3][4][6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Randomized controlled study

Braga

Hirata

et al. 2014

Acta Cir. Bras.

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“…Como procedimento anestésico, utilizou-se mais a raquianestesia, presente em 61% dos casos, seguida pela geral balanceada (25%). O grande número de pacientes que recebeu a raquianestesia é, em parte, devido ao número de cesáreas realizadas, pois essa anestesia é preconizada para esse procedimento cirúrgico (26) . Com menor frequência, usou-se a anestesia de bloqueio e a local (2% cada).…”

Section: Discussionunclassified

Dor pós-operatória em hospital universitário: perspectivas para promoção de saúde

Franco

Sugai

Silva

et al. 2017

RBPS

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Thaís de Carvalho da SilvaUniversidade José do Rosário Vellano -UNIFENAS -Alfenas -(MG) -Brasil Roberta Bessa Veloso SilvaUniversidade José do Rosário Vellano -UNIFENAS -Alfenas -(MG) -Brasil Roberto Salvador de Souza Guimarães Universidade José do Rosário Vellano -UNIFENAS -Alfenas -(MG) -Brasil Cláudio Daniel Cerdeira Universidade Federal de Alfenas -UNIFAL -Alfenas -(MG) -Brasil Gérsika Bittencourt SantosUniversidade José do Rosário Vellano -UNIFENAS -Alfenas -(MG) -Brasil RESUMOObjetivo: Avaliar a prevalência, os fatores influentes e a magnitude da dor pós-operatória (DPO) em pacientes atendidos em um hospital universitário. Métodos: Realizou-se estudo prospectivo e transversal envolvendo 100 pacientes submetidos a diferentes procedimentos cirúrgicos, no período de março a maio de 2016, entrevistados nas primeiras 24 horas do pós-operatório e avaliados através de uma escala visual numérica (EVN). Resultados: As cirurgias mais comuns encontradas são: cesárea, apendicectomia, prostatectomia, tireoidectomia total e osteossíntese; e as anestesias: raquianestesia e geral balanceada, sendo a prevalência de DPO menor quando usada a raquianestesia. Dos pacientes, 43% (n = 43) declararam DPO, com prevalência de 44% (n = 14) para o sexo masculino e 43% (n = 29) para o feminino. Entre esses, 30% (n = 13) classificaram a DPO como de intensidade forte, 53,5% (n = 23) classificaram como moderada, e 14% (n = 6), leve. Houve maior prevalência de DPO nas faixas etárias de 25-34 e 55-64 anos, e relações causais significativas entre o sexo do paciente e as variáveis diagnóstico, tipo de cirurgia, local ou intensidade da dor. Além disso, o local da DPO relacionou-se com a faixa etária ou tipo de cirurgia, e a intensidade se relacionou com a faixa etária. Conclusão: A dor pós-operatória no hospital universitário em questão se apresentou prevalente em pacientes de ambos os sexos e dependente da faixa etária, da heterogeneidade de procedimentos cirúrgicos e de protocolos anestésicos, sendo a de intensidade moderada a mais identificada.Descritores: Dor; Cirurgia Geral; Prevalência; Epidemiologia.

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“…Clonidine is an α 2 -adrenoceptor agonist that can be used as an adjuvant to other analgesics to improve postoperative analgesia [8,[16][17][18][19][20][21][22][23][24][25][26][27]. When administered intrathecally, clonidine results in analgesia by reducing the release of substance P, modulating N-methyl-D-aspartate receptors, increasing acetylcholine concentrations in the cerebrospinal fluid, and increasing the production of nitric oxide [16,19,20,[28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Randomized study of postcesarean analgesia with intrathecal morphine alone or combined with clonidine

Carvalho¹,

Tenório

Shiohara³

et al. 2016

Journal of Clinical Anesthesia

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Spinal Anesthesia for Cesarean Section. Use of Hyperbaric Bupivacaine (10mg) Combined with Different Adjuvants

Abstract: Addition of sufentanil and clonidine to hyperbaric bupivacaine provided adequate anesthesia for cesarean section and good postoperative analgesia. Clonidine caused more perioperative sedation and longer time to motor block recovery. Pruritus was evident when opioids were used.

Cited by 28 publications

References 25 publications

Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Randomized controlled study

Association of lipophilic opioids and hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Randomized controlled study

Dor pós-operatória em hospital universitário: perspectivas para promoção de saúde

Randomized study of postcesarean analgesia with intrathecal morphine alone or combined with clonidine

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