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Korean Journal of Anesthesiology 2000;39(6):786-791.
DOI: https://doi.org/10.4097/kjae.2000.39.6.786   
Comparison of Intrathecal Isobaric and Hyperbaric Bupivacaine during Combined Spinal Epidural Anesthesia for Cesarean Section.
Jong In Han, Dong Yeon Kim
Department of Anesthesiology, Ewha Womans University College of Medicine, Seoul, Korea.
We aimed to compare the clinical effects of 7 mg of intrathecal isobaric and hyperbaric 0.5% bupivacaine during combined spinal epidural (CSE) anesthesia for a cesarean section. METHODS: Thirty patients scheduled for an elective cesarean section under the CSE technique were randomly divided into two groups. 0.5% hyperbaric bupivacaine (Hyperbaric group, n = 15) or 0.5% isobaric bupivacaine (Isobaric group, n = 15) was separately injected into the subarachnoid space through a 26 G Quincke needle. Immediately after fixing the epidural catheter, 2% lidocaine 4 ml and fentanyl 50 microgram were injected through the epidural catheter. We measured the level and time of maximal sensory block, hemodynamic variables and many other clinical effects according to times. RESULTS: The level of maximal sensory block and duration of sensory block were not significantly different between the two groups. The time to maximal sensory block was significantly shorter in group I. Five of group H and two of group I needed an additional injection of epidural lidocaine and two of group H and four of group I needed IV fentanyl. However, all patients had the operation in comfort. CONCLUSIONS: An intrathecal injection of 7 mg of isobaric or hyperbaric 0.5% bupivacaine both with an epidural dose of 2% lidocaine 4 ml and fentanyl 50 microgram during CSE anesthesia is suitable for an elective cesarean section.
Key Words: Anesthetics, local: bupivacaine; lidocaine; Anesthetic technique: combined spinal epidural; Surgery: cesarean section


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