| Spinal Anesthesia for Cesarean Section: A comparison of three doses of hyperbaric bupivacaine and the effects of fentanyl. |
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Duck Hwan Choi, Hyun Joo Ahn, Ik Soo Chung |
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Department of Anesthesiology, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea. |
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| Abstract |
BACKGROUND
Spinal anesthesia has several advantages in cesarean section. Those are rapid induction, complete analgesia, profound muscle relaxation, low failure rate and systemic toxicity. But the determination of anesthetic level is more difficult in spinal anesthesia than in epidural anesthesia. So we would like to determine the appropriate dosage of 0.5% hyperbaric bupivacaine and the effects of addition of intrathecal fentanyl.
METHODS
Sixty full term parturiants scheduled for cesarean section were randomly received 0.5% hyperbaric bupivacaine 8, 10, 12 mg intrathecally. Analgesia, sensory and motor blockade, muscle relaxation, hypotension and side effects were assessed. We compared these results with the previous study that was done with the same dosages mixed with 10 microgram fentanyl.
RESULTS
The maximum level of block was higher in 12 mg group (T2) then 8 and 10 mg group (T3). 5 parturients showed more than T1 sensory block in 12 mg group (n=20). 4 parturients did not reach T4 in 8 mg group (n=20). 7, 4 and 0 parturients complained pain during operation in each 8, 10, 12 mg group (p=0.012 between 8 and 12 mg group, p=0.062 between 10 and 12 mg group). Addition of 10 microgram fentanyl showed better analgesia and less shivering.
CONCLUSION
Intrathecal 0.5% hyperbaric bupivacaine 12 mg showed complete analgesia for all parturients but the tendency of high spinal anesthesia. Analgesia was inadequate in 8 mg group. Addition of 10 microgram fentanyl showed better analgesia and less shivering. |
| Key Words:
Analgesics, fentanyl; Anesthetics, local, bupivacaine; Anesthetic technique, spinal; Surgery, cesarean section |
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