scholarly journals Influence of Positioning on Plain Levobupivacaine Spinal Anesthesia in Cesarean Section

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Fabio Gori ◽  
Francesco Corradetti ◽  
Vittorio Cerotto ◽  
Vito Aldo Peduto
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Supine Position ◽  
Motor Block ◽  
Sensory Block ◽  
Sensory Level ◽  
Physical Status ◽  
Gravitational Forces ◽  
Block Level ◽  
Dermatomal Level

Background. The behaviour of isobaric levobupivacaine in relation to gravity when used in obstetric spinal anesthesia is unclear.Methods. 46 women with ASA physical status 1 undergoing cesarean section were randomly allocated to 2 groups. Spinal anesthesia with 12.5 mg levobupivacaine was performed in the sitting position in all women. Those in the first group were placed in the supine position immediately after the injection, while those in the second group were asked to remain seated for 2 minutes before assuming the supine position. The sensory block level, the onset of sensory and motor blocks, the regression of the sensory block for 2 dermatomes of the sensory block, the first request for analgesics, and the regression of motor block were recorded.Results. No differences in onset times, sensory level, or Bromage score were observed between the two groups. The time of first analgesic request was earlier in the seated group (supine131±42 min, seated106±29 min,P=.02).Conclusion. Isobaric levobupivacaine in women at term produces a subarachnoid block the dermatomal level of which does not depend on gravitational forces.

scholarly journals Comparison of effects of Bupivacaine and Ropivacaine in patients undergoing elective Caesarean section

2020 ◽  
Vol 4 (3) ◽  
pp. 859-863
Author(s):  
Sangeeta Subba ◽  
Arjun Arjun Chhetri ◽  
Rupak Bhattarai
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Elective Caesarean Section ◽  
Sensory Block ◽  
Elective Cesarean Section ◽  
Hyperbaric Bupivacaine ◽  
Safe Alternative ◽  
Elective Cesarean ◽  
Group B

Introduction: Spinal anesthesia is considered a reasonable choice for cesarean section. Bupivacaine and ropivacaine have been used as intrathecal drugs alone or in combination with various opioids. Ropivacaine is considered a valid and safe alternative to bupivacaine for spinal anesthesia. Objectives: To compare the efficacy and safety of hyperbaric ropivacaine with hyperbaric bupivacaine in spinal anesthesia for elective cesarean section. Methodology: Sixty pregnant women undergoing elective cesarean section were allocated into two groups. Group R received 3 ml of 0.5% hyperbaric ropivacaine (2 ml 0.75% plain ropivacaine mixed with 1 ml of 25 %dextrose) and Group B received 2.5 ml of 0.5% hyperbaric bupivacaine. Both the groups were compared in terms of onset of sensory and motor block, regression of sensory and motor block, duration of analgesia and side effects. Results: The onset of sensory block was comparable in both groups but was statistically insignificant. The onset of motor block in Bupivacaine(7.53 ± 1.72) min was faster when compared to Ropivacaine group(14.33 ± 6.19) min. Regression of sensory and motor block both were faster in Ropivacaine group. Duration of analgesia was longer in Bupivacaine group(131.17 ± 32.95)min than Ropivacaine group(125.33 ± 30.54)min. Conclusion: Ropivacaine can be used as an alternative to Bupivacaine for spinal anesthesia in cesarean section but has a shorter duration of sensory and motor block.

The Effect of Intra-Abdominal Pressure on Sensory Block Level of Single-Shot Spinal Anesthesia for Cesarean Section

2016 ◽  
Vol 36 (1) ◽  
pp. 50-51
Author(s):  
T. Ozkan Seyhan ◽  
M. Orhan-Sungur ◽  
B. Basaran ◽  
M. Savran Karadeniz ◽  
F. Demircan ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Abdominal Pressure ◽  
Single Shot ◽  
Block Level

scholarly journals Correlation between anthropometric measurements and sensory block level of spinal anesthesia for cesarean section

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Hyojoong Kim ◽  
Sung Hyun Shin ◽  
Myoung Jin Ko ◽  
Yei Heum Park ◽  
Ki Hwa Lee ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Anthropometric Measurements ◽  
Abdominal Circumference ◽  
Hip Circumference ◽  
Height Ratio ◽  
Hyperbaric Bupivacaine ◽  
Spinal Anesthetic ◽  
Block Level

Background: When performing spinal anesthesia for cesarean section, it is important to determine the appropriate anesthetic dose as well as to predict the level of spinal anesthesia. In this study, it was hypothesized that some anthropometric measurements may be related to maximum sensory block and hemodynamic changes. Objectives: The aim of this study are to find maternal anthropometric values that are correlate with the level of spinal anesthesia. Methods: Maternal anthropometric measurements, including height, weight, supine and standing abdominal circumference (AC), and hip circumference, were recorded before spinal anesthesia for cesarean section. Spinal anesthesia was induced by administering 8 mg of 0.5% hyperbaric bupivacaine and 20 μg of fentanyl at the L3-L4 interspace. The level of sensory block was determined using pin-prick at 1, 5, 10, and 15 minutes after spinal anesthesia. The sensory block level and hemodynamic adverse events were analyzed in relationship to anthropometric measurements. Results: The supine AC/height ratios significantly correlate with the maximal sensory block level at 5, 10, and 15 minutes after the injection of spinal anesthetic (p = 0.001, p < 0.001 and p < 0.001, respectively). Further, there were significant correlations between body mass index (BMI) and sensory block level at every assessment (p = 0.041, p = 0.002, p = 0.001 and p < 0.001, respectively). When comparing the groups with and without hypotension, BMI, weight, and supine AC/height ratio were found to be significantly higher in the group with hypotension (p = 0.002, p = 0.004 and p = 0.006, respectively). Conclusions: We conclude that BMI and AC/height ratio correlate with the sensory block level of spinal anesthesia for cesarean section.

scholarly journals Comparative Study of Effect of Spinal Anesthesia in Sitting and Lateral Positions on the Onset Time of Sensory Block and Hemodynamic Condition in Cesarean Section: A Randomized Clinical Trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nahid Manouchehrian ◽  
Abbas Moradi ◽  
Leyla Torkashvand
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Onset Time ◽  
Sensory Block ◽  
Lateral Position ◽  
Sitting Position ◽  
Cesarean Sections ◽  
Position Group

Background: Spinal anesthesia is the method of choice for the cesarean section. Hypotension is a common complication of this method. Objectives: This study aimed to compare the effect of spinal anesthesia in the sitting and lateral positions on the onset time of sensory block and hemodynamic condition in cesarean sections. Methods: In this clinical trial, 106 elective cesarean section candidates under spinal anesthesia were selected and randomly divided into two groups: spinal anesthesia in the sitting position (group S) and the lateral position (group L). The onset time of the sensory block, quality of sensory and motor block, hemodynamic condition, frequency of hypotension, nausea, and vomiting, and the doses of ephedrine and atropine were compared between both groups. Data were analyzed with SPSS version 16 software at a 95% confidence level. Results: There was no statistically significant difference between the two groups in terms of age. The frequency of hypotension in L and S groups was 24.5% and 57.7%, respectively (P = 0.001), in minute 6 after spinal anesthesia and 5.7% and 36.5%, respectively (P < 0.001), in minute 8 after spinal anesthesia. The mean time to reach the sensory level of T6 was 1.30 ± 0.43 min versus 4.54 ± 2.12 min (P < 0.001), motor block score in minute 5 was 2.98 ± 0.14 versus 2.82 (P = 0.044), and ephedrine dose was 11.5 mg and 16.92 mg in the L and S groups, respectively (P = 0.010). The maximum sensory-motor block and satisfaction of women with spinal anesthesia were significantly higher in the lateral position than in the sitting position (P < 0.05). Conclusions: Cesarean sections under spinal anesthesia in the lateral position than in the sitting position lead to a more rapid sensory and motor block, reduced ephedrine consumption, and enhanced satisfaction of women.

scholarly journals Comparative evaluation of intrathecal bupivacaine alone and bupivacaine combined with dexmedetomidine in cesarean section using spinal anesthesia: a meta-analysis

2019 ◽  
Vol 47 (7) ◽  
pp. 2785-2799 ◽  
Author(s):  
Xin Liu ◽  
Xiongjie Zhang ◽  
Xujian Wang ◽  
Jinyan Wang ◽  
Hao Wang
Keyword(s):  
Confidence Interval ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Outcome Measure ◽  
Meta Analysis ◽  
Sensory Block ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Control Group ◽  
Block Level

Objective This meta-analysis was performed to evaluate the effect of spinal anesthesia (SA) using bupivacaine combined with dexmedetomidine (DEX) in cesarean section, analyze the adverse drug reactions induced by this mixture, and provide a reference for rational drug use. Methods Randomized controlled trials were obtained from the PubMed, Cochrane Library, and Embase databases. The primary outcome measure was the time to the highest sensory block level (min), and the secondary outcome measure was adverse effects. Results The time to the highest sensory block level was significantly shorter in the bupivacaine-DEX group than in the control group (standardized mean difference, −0.23; 95% confidence interval, −0.43 to −0.03). The incidence of shivering during the process of anesthesia, especially at a dose of 5 µg DEX, was significantly lower in the bupivacaine-DEX group than in the control group (odds ratio, 0.26; 95% confidence interval, 0.14–0.49). No significant differences were observed in the symptoms of hypotension, bradycardia, nausea/vomiting, or pruritus. Conclusion Compared with the use of bupivacaine alone for SA in cesarean section, adding dexmedetomidine during SA can significantly shorten the onset time and decrease the rate of shivering during anesthesia.

scholarly journals Perbandingan Efek 10 Mg dengan 12,5 Mg Levobupivacain 0,5% Isobarik terhadap Onset, Durasi, dan Hemodinamik pada Spinal Anestesi untuk Seksio Sesarea

2020 ◽  
Vol 2 (2) ◽  
pp. 71-8
Author(s):  
Rachmad Ismail ◽  
Muh Ramli Ahmad ◽  
A. Muh. Takdir Musba
Keyword(s):  
Data Analysis ◽  
Side Effects ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Sensory Block ◽  
Hemodynamic Changes ◽  
Group Data ◽  
Significant Difference ◽  
Sensory Motor

Latar Belakang: Tujuan utama spinal anestesi pada seksio sesarea adalah meminimalkan efek samping pada ibu dan bayi baru lahir. Levobupivacain memiliki mekanisme aksi yang sama dengan anestesi lokal lainnya, akan tetapi memiliki efek toksik pada jantung dan saraf yang lebih kecil. Tujuan: Membandingkan onset/durasi blok sensorik, motorik serta hemodinamik antara 10 Mg dengan 12,5 Mg Levobupivacain 0,5% Isobarik + fentanyl 25 μg pada seksio sesarea dengan anestesi spinal.Metode: Sampel terdiri dari dua kelompok, kelompok pertama menerima 10 Mg Levobupivacain 0,5% Isobarik + fentanyl 25 μg dan kelompok kedua menerima 12,5 Mg Levobupivacain 0,5% Isobarik + fentanyl 25 μg dengan sampel masing-masing kelompok 23 orang. Analisis data menggunakan uji statistik uji T independen.Hasil: Onset blok sensorik lebih cepat pada kelompok 12,5 Mg Levobupivacain (2,30 menit) dibandingkan kelompok 10 Mg Levobupivacain (3,70 menit), hal ini secara statistik menunjukkan perbedaan yang signifikan. Durasi blok sensorik kelompok 12,5 Mg Levobupivacain (187,39 menit), durasi blok motorik (194,57 menit) lebih lama dibandingkan kelompok 10 Mg Levobupivacain durasi blok sensorik (153,48 menit) dan durasi blok motorik (157,83 menit). Tidak ada perbedaan yang signifikan pada perubahan hemodinamik untuk kedua kelompokSimpulan: Onset blok sensorik kelompok 12,5 Mg Levobupivacain lebih cepat dibandingkan kelompok 10 Mg Levobupivacain, durasi blok sensorik dan blok motorik kelompok 12,5 Mg Levobupivacain lebih lama dibandingkan kelompok 10 Mg Levobupivacain. Comparison Effects 10 Mg with 12.5 Mg Levobupivacain 0.5% Isobaric Against Onset, Duration, and Hemodynamics in Spinal Anesthesia of Caesarean Section Abstract Background: The main purpose of spinal anesthesia in cesarean section is to minimize side effects on the mother and newborn baby. Levobupivacaine has the same mechanism of action as other local anesthetics, but has a smaller toxic effect on the heart and nerves.Objective: Comparing the onset / duration of sensory, motor and hemodynamic blocks between 10 Mg and 12.5 Mg Levobupivacain 0.5% Isobaric + 25 μg fentanyl in cesarean section with spinal anesthesia.Methods: The sample consisted of two groups, the first group received 10 Mg Levobupivacain 0.5% Isobaric + fentanyl 25 μg and the second group received 12.5 Mg Levobupivacain 0.5% Isobaric + fentanyl 25 μg with a sample of 23 people each group. Data analysis using independent T test statistical tests.Results: Sensory block onset was faster in the 12.5 Mg Levobupivacain group (2.30 minutes) than the 10 Mg Levobupivacain group (3.70 minutes), this statistically showed a significant difference. The sensory block duration of the 12.5 Mg Levobupivacain group (187.39 minutes), the motor block duration (194.57 minutes) is longer than the 10 Mg Levobupivacain group the duration of the sensory block (153.48 minutes) and the duration of the motor block (157.83 minutes). There were no significant differences in hemodynamic changes for the two groups.Conclusion: The onset of the 12.5 Mg Levobupivacain sensory block was faster than the 10 Mg Levobupivacain group, the duration of the sensory block and motor block of the 12.5 Mg Levobupivacain group was longer than the 10 Mg Levobupivacain group

scholarly journals Comparison of Hypobaric Bupivacaine, With and Without Fentanyl for Patients Undergoing Surgeries around Hip: A Randomized Double Blind Study from North India

2020 ◽  
Vol 5 (1) ◽  
pp. 52-56
Author(s):  
Anshuman Shukla ◽  
Sumita Kumari ◽  
Vinita Singh ◽  
Satyajeet Verma ◽  
Sujeet Rai
Keyword(s):  
Spinal Anesthesia ◽  
Motor Block ◽  
Sensory Block ◽  
Motor Recovery ◽  
P Value ◽  
Sensory Level ◽  
Single Shot ◽  
Distilled Water ◽  
Spinal Injection ◽  
Operating Side

Background: Hip surgeries are frequently performed using single shot spinal anesthesia with 15-17.5 mg plain bupivacaine 0.5% which provides surgical anesthesia for 3-4 hours but is difficult to make the patients with hip fractures to lie in lateral decubitus position with the operating side dependent and to make them sit also. Using hypobaric local anesthetic for surgeries around hip, preparation time may be reduced for performing spinal anesthesia and surgery in the same position without waiting for establishment of spinal anesthesia in the supine position. Furthermore, hypobaric local anesthetics can produce more selective block on the operating side and avoid unnecessary paralysis of the nonoperating side potentially resulting in hemodynamic stability and better mobilization of patients during recovery period.Subjects and Methods:In the present study, we compared the anesthetic and hemodynamic effects of hypobaric bupivacaine with and without fentanyl in 100 ASA physical status I and II patients undergoing surgeries around hip. Patients received spinal injection of either 2.5ml (12.5mg) of isobaric bupivacaine with 1.5ml of distilled water (total 4ml) making it hypobaric or 2.5 ml (12.5mg) of isobaric bupivacaine with 1ml of distilled water and 0.5ml(25 µg) of fentanyl (total 4ml) with operative side up, in a double blinded manner. Sensory level and motor block were evaluated on the operative and non-operative sides until regression to L2 and full motor recovery. Hemodynamic changes after spinal injection and the first analgesic request for VAS >3 were noted.Results:Demographic characteristics of both the groups were comparable. Time to maximal fall in MAP and patients requiring vasopressor were similar in both the groups. None of the patients in any of the two group required atropine for bradycardia. Co-administration of fentanyl in hypobaric bupivacaine hastened the onset of sensory block (12±3 vs. 20±9.0, p value <0.001) and the time required was less on the operative side than on the contralateral (non-operative) side in both the groups. The median upper level of block was higher on the operative than on the contralateral side in both the groups. Co-administration of fentanyl in hypobaric bupivacaine prolonged the sensory regression to L2 (298±40 vs. 256±35, p value <0.001). Co-administration of fentanyl had no effect on the time to complete motor recovery as at the end of surgery, all the patients had complete motor recovery on the contralateral (non-operative) side, while none of the patient in any of the two groups had complete motor recovery on the operative side. Time to first analgesic requirement was significantly higher (318±27 vs. 288±28, p value <0.001) with the addition of fentanyl to the hypobaric bupivacaine.Conclusion:So we conclude that the use of hypobaric bupivacaine produces spinal anesthesia with a faster sensory motor recovery on the contralateral (non-operative) side. Co-administration of fentanyl further prolongs the sensory block on the operative side without significantly affecting the motor block, so delays the use of first analgesic without further compromising the systemic hemodynamics.

scholarly journals Dexmedetomidine as an adjuvant for single spinal anesthesia in patients undergoing cesarean section: a system review and meta-analysis

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052091342
Author(s):  
Qi-hong Shen ◽  
Hui-fang Li ◽  
Xu-yan Zhou ◽  
Xiao-zong Yuan ◽  
Ya-ping Lu
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Motor Block ◽  
Scientific Journal ◽  
Onset Time ◽  
Sensory Block ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Significant Difference ◽  
The Impact

Objective Previous studies reported the effect of dexmedetomidine on intrathecal anesthesia. In this review, we explored the impact of dexmedetomidine as an adjunct for lumbar anesthesia in patients undergoing cesarean section. Methods Two authors searched eligible random controlled trials in electronic databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, the Chinese BioMedical database, Chinese Scientific Journal Database, and the Wanfang database. Results Ten trials comprising 970 patients were included in this review. Intrathecal dexmedetomidine significantly reduced the onset time of sensory block (standardized mean difference (SMD), −1.50, 95% confidence interval (CI) −2.15, −0.85, I2 = 92%) and motor block (SMD −0.77, 95% CI −1.50, −0.49, I2 = 60%) and prolonged the block duration time (sensory block: SMD 2.02, 95% CI 1.29, 2.74, I2 = 93%; motor block: SMD 1.90, 95% CI 1.07, 2.74, I2 = 94%). Patients who received dexmedetomidine showed a lower incidence of shivering. No significant difference was reported for the neonatal Apgar score and other complications. Conclusion The use of intrathecal dexmedetomidine during cesarean section can shorten the onset time of spinal anesthesia and enhance the effect of local anesthetic. It has no significant impact on neonates and there were no other adverse events.

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