| Spinal Anesthesia for Cesarean Section: A comparison of three doses of hyperbaric bupivacaine mixed with fentanyl. |
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Duck Hwan Choi, Youn Jeong Kang, Ik Soo Chung |
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Department of Anesthesiology, Sung Kyun Kwan University, College of Medicine Samsung Medical Center, Seoul, Korea. |
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| Abstract |
BACKGROUND
Spinal anesthesia for cesarean section is regaining popularity because it offers better intraoperative analgesia and relaxation than epidural anesthesia.
Hyperbaric bupivacaine has been known to ameliorate visceral pain more than tetracaine and fentanyl seems to potentiate analgesic effect of bupivacaine. We evaluated if adding fentanyl reduce the dose of spinal hyperbaric bupivacaine.
METHODS
Sixty healthy term parturients scheduled for elective cesarean section randomly received 8, 10 or 12 mg of 0.5% hyperbaric bupivacaine intrathecally, which was mixed with fentanyl 10 g. Intraoperative analgesia was checked with visual analog scale. Sensory blockade variables such as time to T4 block, maximal block height, time to maximal block height, time to and degree of motor block and muscle relaxation were assessed. We also checked side effects and times of regression to T10, complete motor recovery and start of postoperative pain.
RESULTS
All patients had no intraoperative pain. The time to sensory block T4 and the level of maximum sensory block were not significantly different between three groups.
Though only 70% of 8 mg group showed complete motor block, which is significantly less than 100% of 10 or 12 mg group (p=0.01), muscle relaxation was equally excellent in three groups. They showed no significant difference in side effects, but sensory and motor recovery and start of postoperative pain were faster in 8 mg group (p<0.05).
CONCLUSION
After mixing with fentanyl 10 g, 10 mg or more of 0.5% hyperbaric bupivacaine was not necessary and 8 mg was enough in spinal anesthesia for cesarean section. |
| Key Words:
Analgesics: fentanyl; Anesthetics, local: bupivacaine; Anesthetic technique: Spinal; Surgery: Cesarean section |
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