scholarly journals Nalbuphine versus dexmedetomidine for treatment of combined spinal-epidural post-anesthetic shivering in pregnant women undergoing cesarean section

2019 ◽  
Vol 47 (9) ◽  
pp. 4442-4453 ◽  
Author(s):  
Jing Sun ◽  
Zhao Zheng ◽  
Yi-Lu Li ◽  
Li-Wei Zou ◽  
Ge-Hui Li ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Epidural Anesthesia ◽  
Randomized Study ◽  
Saline Group ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Combined Spinal Epidural ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

Objective This study aimed to compare the clinical efficacy and side effects of nalbuphine and dexmedetomidine for treatment of combined spinal-epidural anesthetic shivering in women after cesarean section. Methods A total of 120 pregnant women, who underwent elective cesarean section under combined spinal-epidural anesthesia, were enrolled in a double-blind, randomized study. These women were randomized into three groups of 40 pregnant women each to receive either saline (group C), nalbuphine 0.07 mg/kg (group N), or dexmedetomidine 0.5 µg/kg (group D) for treatment of shivering after anesthesia. The main outcome measure was a significant reduction in the time required for shivering after intervention. Results The mean time to cessation of shivering in groups N and D was significantly shorter than that in group C (3.5±2.7 and 4.2±3.7 versus 14.5±1.4 minutes). The success rate of shivering treatment and Observer’s Assessment of Alertness/Sedation scores in groups N and D were significantly higher than those in group C, while the recurrence rate was lower than that in group C. Conclusion Nalbuphine 0.07 mg/kg can be used safely and effectively for shivering in pregnant women under combined spinal-epidural anesthesia.

scholarly journals Distinguishing cerebrospinal fluid from mepivacaine using the pH test in patients undergoing elective cesarean section with combined spinal-epidural anesthesia

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiromi Ikegami ◽  
Kunihisa Hotta ◽  
Yoshie Toba
Keyword(s):  
Cerebrospinal Fluid ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Epidural Anesthesia ◽  
Reliable Method ◽  
Cutoff Value ◽  
Ph Values ◽  
Combined Spinal Epidural ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

Abstract Introduction In single-space combined spinal-epidural anesthesia (CSEA), it is important to correctly determine if the fluid coming out of the spinal needle is cerebrospinal fluid (CSF) or the liquid used in the loss of resistance (LOR) technique. In this study, we used mepivacaine for LOR and measured the pH values of CSF and mepivacaine to determine whether the pH test is a reliable method to confirm CSF when performing single-space CSEA. Methods This clinical trial included 47 full-term pregnant women who underwent cesarean section. Single-space CSEA was administered at the lumbar intervertebral space using a small amount of mepivacaine for LOR. The pH values of CSF and mepivacaine were determined by the color of the test strip immediately after dropping. The area under the curve (AUC) for the pH values was calculated to determine the cutoff value for distinguishing between CSF and mepivacaine. Results The median pH values were 7.7 (7.1–8.0) and 6.2 (5.9–6.8) for CSF and mepivacaine, respectively. When the cutoff value of pH for distinguishing CSF from mepivacaine was 7.1 or greater, the AUC was 1.0 (100% sensitivity and specificity). Our result demonstrated that CSF can be correctly distinguished from mepivacaine in patients undergoing cesarean section under single-space CSEA using a cutoff value of pH 7.1. Conclusion The pH test is a simple and reliable method to confirm CSF when performing single-space CSEA with mepivacaine for LOR. Trial registration Accuracy of pH test paper for cerebrospinal fluid during spinal anesthesia: prospective study in healthy pregnant women under scheduled caesarean section; University Hospital Medical Information Network, UMIN000036454. Registered 1 May 2019

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