The Effect of Different Doses of Intrathecal Hyperbaric Bupivacaine Plus Sufentanil in Spinal Anesthesia for Cesarean Sections

Alimian, Mahzad; Mohseni, Masood; Faiz, Seyed Hamid Reza; Rajabi, Alireza

doi:10.5812/aapm.14426

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…It is worthy of note that the frequency of maternal nausea and vomiting was low. Similar rates were reported in studies where low doses of LA were used [14,28]. Therefore, the results of our study do not support the notion that adjusting conventional doses of bupivacaine to patient's height will prevent nausea and vomiting.…”

Section: Discussioncontrasting

confidence: 53%

Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial

Białowolska¹,

Horosz²,

Sękowska³

et al. 2020

JCM

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The optimal intrathecal dose of local anaesthetic for caesarean section (CS) anaesthesia is still being debated. We performed a study to compare the effectiveness and safety of spinal anaesthesia with 12.5 mg of hyperbaric bupivacaine and a dosing regimen of conventional doses adjusted to parturient height. One hundred and forty parturients scheduled for elective CS were enrolled. The fixed-dose group (FD) received a spinal block with 12.5 mg of hyperbaric bupivacaine with fentanyl, whereas the adjusted-dose group (AD) received a height-adjusted dose of bupivacaine (9–13 mg) with fentanyl. Sensory block ≥ T5 dermatome within 10 min and no need for supplementary analgesia were set as the composite primary outcome (success). Rates of successful blocks and complications were compared. Complete data were available for 134 cases. Spinal anaesthesia was successful in 58 out of 67 patients in the FD group and 57 out of 67 in the AD group (p > 0.05). Eight spinals in each group failed to produce a block ≥ T5 in 10 min, and one patient in the FD group and two in the AD group required i.v. analgesics despite sensory block ≥ T5. No differences were noted in terms of hypotension, bradycardia and nausea between the FD and AD groups. Compared to the height-adjusted dose regimen based on conventional doses of hyperbaric bupivacaine, the fixed dose regimen of 12.5 mg was equally effective and did not increase the risk of spinal block-related complications.

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Section: Discussioncontrasting

confidence: 53%

Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial

Białowolska¹,

Horosz²,

Sękowska³

et al. 2020

JCM

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“…This was likely because these patients received a higher dose of phenylephrine. Alimian et al [24] , reported that mean preoperative MAP was comparable in three groups (8mg, 9mg, 10mg). The trend of MAP was comparable in the 3 groups even after anesthetic dose (P>0.05).…”

Section: Mean Arterial Pressurementioning

confidence: 96%

“…(Table 4) Other comparative studies also had no significant difference in the demographic variables among the groups. [21][22][23][24][25][26][27] Cenkowski et al [22] , reported that the average age in the conventional dose group was 31±3 versus 32 ± 6 years in the low dose group, Venkata et al [25] , study group had comparable mean age of the patients (24±2.1 vs 23±1.5); comparable weight (68±5.0 vs 64±4.84); comparable height (156±6.5 vs 158±9.0); and comparable ASA status (I/II vs I/II) (P>0.05), Mebazaa et al [20] as compared to conventional dose group (Group A), low-dose Group (Group B) had similar age (33 ± 6 vs 32 ± 5); similar weight (78 ± 10 vs 77 ± 9); similar height (…”

Section: Demographic Datamentioning

confidence: 99%

A randomized prospective study comparing conventional dose to low dose of hyperbaric bupivacaine for spinal anaesthesia in elective caesarean section

Singh¹,

Varshney²,

Jheetay³

et al. 2020

Int. J. Med. Anesthesiology

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Background: For caesarean sections, local anesthetics e.g. bupivacaine, chloroprocaine, levobupivacaine, lidocaine, ropivacaine, and tetracaine have been used generally in combination usually with opioids like morphine or fentanyl or its derivatives. Aim and Objectives: Thus this study was conducted to compare the efficacy of two different doses of 0.5% hyperbaric bupivacaine (7.5mg and 10mg) in women undergoing caesarean section. Materials and Method:The study was conducted in the Department of Anaesthesiology, Teerthanker Mahaveer hospital, TMU, Moradabad among 80 American Society of Anaesthesiologists (ASA) physical status I and II patients scheduled for elective caesarean section. The spinal anaesthetic haemodynamic parameters, i.e., Heart Rate, Non Invasive Blood Pressure, ECG, MAP and SpO2 were monitored. The sensory and motor onset time and time to regression were recorded. Results: Group B patients had significantly higher pulse rate post-spinal(P<0.05); significantly lower pulse rate at 6,8,10,16,19,25,30,35,40,45 and 60 minutes. Group B patients had significantly high systolic blood pressure post-spinal, at 2, 4, 6, 35, and 50 minutes. Group B patients took significantly more time to attain maximum motor and sensory block than group A. APGAR scores of the neonates born to the patients of the two groups were compared. Group B patients had significantly high mean diastolic and MAP post-spinal, 2, 4, and at 6 minutes. Conclusion: Low dose (7.mg) Bupivacaine shows better hemodynamic stability whereas the conventional dose (10mg) showed a faster onset/duration of sensory block and a prolonged motor block.

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“…Administration of an appropriate dose hyperbaric bupivacaine can minimize potential side effects while improving block quality ( 18 ). However, the optimal intrathecal dose of hyperbaric bupivacaine for SPA is still being debated.…”

Section: Introductionmentioning

confidence: 99%

Comparison between 10 and 12 mg doses of intrathecal hyperbaric (0.5%) bupivacaine on sensory block level after first spinal failure in cesarean section: A double-blind, randomized clinical trial

et al. 2022

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BackgroundReducing adverse effects during cesarean delivery and improving the quality of sensory blocks with appropriate doses of intrathecal hyperbaric bupivacaine can play an important role in the safe management of cesarean delivery. The aim of this study was to compare the doses of 10 and 12 mg of intrathecal hyperbaric bupivacaine 0.5% on sensory block level after first spinal failure in cesarean section (CS).MethodsIn this double-blind, randomized clinical trial, 40 candidates of CS after first spinal failure with class I-II based on American Society of Anesthesiologists (ASA) were randomly assigned into two equal groups (n = 20). Group A and B received the spinal anesthesia with 10 mg and 12 mg of hyperbaric bupivacaine (0.5%), respectively. Maximum levels of sensory block, motor block quality, and vital signs were measured in two groups by 60 min after SPA. Incidence of SPA complications during surgery were also recorded. Data were analyzed by SPSS ver.21 software using repeated measures analysis of variance at 95% confidence interval (CI) level.ResultsExcellent quality of sensory blocks and complete quality of motor blocks were achieved in all participants (100%). However, the mean time to onset of anesthesia (4.47 ± 0.69 vs. 3.38 ± 0.47, P < 0.001) and time to reach T10 level (60.73 ± 11.92 vs. 79.00 ± 19.21, P < 0.001) in the Group A, were significantly shorter than in the patients of Group B. The incidence of hypotension (P = 0.001), nausea/vomiting (P = 0.007) and bradycardia (P = 0.012) as well as administration of ephedrine and atropine were significantly higher in Group B compared to Group A.ConclusionSpinal anesthesia can be safely repeated with a 10 mg of hyperbaric bupivacaine 0.5% in a caesarean section after the initial spinal failure.Clinical trial registration[https://en.irct.ir/trial/40714], identifier [IRCT20120915010841N20].

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The Effect of Different Doses of Intrathecal Hyperbaric Bupivacaine Plus Sufentanil in Spinal Anesthesia for Cesarean Sections

Cited by 5 publications

References 13 publications

Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial

Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial

A randomized prospective study comparing conventional dose to low dose of hyperbaric bupivacaine for spinal anaesthesia in elective caesarean section

Comparison between 10 and 12 mg doses of intrathecal hyperbaric (0.5%) bupivacaine on sensory block level after first spinal failure in cesarean section: A double-blind, randomized clinical trial

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