scholarly journals Addition of Adrenaline to Chloroprocaine Provides a Moderate Duration Time for Epidural Anaesthesia in Elective Caesarean Section

2012 ◽  
Vol 40 (3) ◽  
pp. 1099-1107 ◽  
Author(s):  
Sw Feng ◽  
Y Cao ◽  
Wg Wang ◽  
Ys Liu ◽  
Xf Shen
Keyword(s):  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Analogue Scale ◽  
Elective Caesarean Section ◽  
Onset Time ◽  
Attractive Alternative ◽  
Cold Sensation ◽  
Time Duration ◽  
Duration Time ◽  
To Receive

OBJECTIVE: Epidural anaesthesia using chloroprocaine with or without adrenaline and lidocaine with adrenaline were compared. METHODS: Sixty parturients undergoing elective caesarean section under epidural anaesthesia were randomized to receive 3% chloroprocaine (group C), 3% chloroprocaine with adrenaline (group CA) or 2% lidocaine with adrenaline (group LA). Onset time, duration time and various maternal, fetal and neonatal parameters were monitored. Pain was assessed using a visual analogue scale. RESULTS: The onset time of analgesia in group CA was similar to that in group C but was shorter than that in group LA. Duration of analgesia, loss of cold sensation and motor blockade in group CA were prolonged compared with group C, but were shorter than those in group LA. No differences in maternal, fetal or neonatal effects were seen. A higher pain score was reported in group C than in groups CA or LA at the end of surgery. CONCLUSIONS: Epidural anaesthesia using chloroprocaine with adrenaline has a quick onset and moderate duration and is an attractive alternative to lidocaine and adrenaline or chloroprocaine alone for caesarean section.

scholarly journals Analgesia after Caesarean Section with Intramuscular Ketorolac or Pethidine

1993 ◽  
Vol 21 (4) ◽  
pp. 420-423 ◽  
Author(s):  
T. Gin ◽  
A. F. Kan ◽  
K. K. Lam ◽  
M. E. O'Meara
Keyword(s):  
Caesarean Section ◽  
Analogue Scale ◽  
Elective Caesarean Section ◽  
Double Blind ◽  
Randomised Study ◽  
Verbal Scale ◽  
To Receive ◽  
Intramuscular Ketorolac ◽  
Variable Quality

We compared, in a double-blind randomised study, intramuscular ketorolac 30 mg (n = 49) and intramuscular pethidine 75 mg (n=5l) for analgesia after elective caesarean section under general anaesthesia. Anaesthesia was induced with thiopentone and suxamethonium and maintained with atracurium, nitrous oxide and isoflurane. Intravenous fentanyl 100 μg was given after delivery of the neonate. In the recovery ward, patients who requested analgesia were allocated randomly to receive ketorolac 30 mg or pethidine 75 mg intramuscularly. Analgesia was assessed at intervals up to six hours, using a visual analogue scale and a four-point verbal scale, while duration of analgesia was taken as the time until the patient requested additional analgesia. There was no difference in the duration of analgesia between groups (Mann-Whitney test P=0.27, Mantel-Haentszel test P=0.17). Twenty-six patients in the ketorolac group and 17 patients in the pethidine group requested further analgesia by 90 minutes. However, four patients in the ketorolac group and six patients in the pethidine group requested no further analgesia within 24 hours. Pain VAS and overall assessment of analgesia was similar between groups, although more side-effects (nausea, dizziness) were noted in the pethidine group. Ketorolac 30 mg and pethidine 75 mg provided similar but variable quality of analgesia after caesarean section.

scholarly journals Bupivacaine 0.5% vs. levobupivacaine 0.5% for epidural anaesthesia for caesarean section: a comparative study

2018 ◽  
Vol 7 (2) ◽  
pp. 343 ◽  
Author(s):  
Heena D. Pahuja ◽  
Megha P. Tajne ◽  
Anjali R. Bhure ◽  
Savita M. Chauhan
Keyword(s):  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Motor Block ◽  
Elective Caesarean Section ◽  
Sensory Block ◽  
Epidural Block ◽  
Elective Cesarean Section ◽  
Significant Difference ◽  
Elective Cesarean ◽  
Mean Time

Background: Levobupivacaine has been purported to be as efficacious as Bupivacaine for epidural anaesthesia in recent literature.Methods: With the intent to study the same in caesarean section cases in our set up, we observed various intra- and post-operative variables in two groups (Levobupivacaine and Bupivacaine) of 60 healthy parturients. Sixty parturients for elective caesarean section were allocated randomly to receive epidural block with 10-20 ml of either 0.5% Levobupivacaine with Fentanyl 25µg or 0.5% Bupivacaine with Fentanyl 25µg to reach T6 level.Results: Mean total volume in Bupivacaine group was 15.23ml and in Levobupivacaine group was 12.76 ml. The difference was statistically significant. There was significant difference between the groups in the sensory block. The onset of analgesia was earlier in Levobupivacaine group. Mean time was 6.20 minutes in Bupivacaine group and 4.36 minutes in Levobupivacaine group. The duration of motor block was significantly short in Levobupivacaine group. Mean Time for recovery from motor block in Bupivacaine group was 2.5 hours and in Levobupivacaine group 1.5 hours. Mean time to achieve T6 height was earlier in Levobupivacaine group i.e. 16.46 minutes in Bupivacaine group and 13.26 minutes in Levobupivacaine group. Duration of postoperative analgesia was similar. There was no significant difference in neonatal outcome.Conclusions: Levobupivacaine was found to fare better than Bupivacaine in the studied intra and post-operative parameters and is hence recommended over racemic Bupivacaine for epidural block in patients undergoing elective cesarean section.

scholarly journals Anaesthetic Management of a Morbidly Obese Parturient for Elective Caesarean Section

2016 ◽  
Vol 10 (2) ◽  
pp. 64-66
Author(s):  
R Pradhan ◽  
S Shrestha ◽  
T Gurung ◽  
AB Shrestha ◽  
KR Sharma
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Epidural Anaesthesia ◽  
Gestational Hypertension ◽  
Elective Caesarean Section ◽  
Anaesthetic Management ◽  
Elective Cesarean Section ◽  
Morbidly Obese ◽  
Elective Cesarean ◽  
Spinal Epidural

Anaesthesia for an obese parturient poses a challenge to anaesthesiologists. Here we report a case of 27 years obese primigravidae at 40 weeks of gestation with gestational hypertension who underwent elective cesarean section under combined spinal epidural anaesthesia. Her intraoperative and postoperative periods were uneventful. 

Spinal or epidural anaesthesia for elective caesarean section?

1992 ◽  
Vol 1 (3) ◽  
pp. 141-144 ◽  
Author(s):  
M. Vegfors ◽  
I. Cederholm ◽  
A. Gupta ◽  
R. Lindgren ◽  
G. Berg
Keyword(s):  
Caesarean Section ◽  
Epidural Anaesthesia ◽  
Elective Caesarean Section

scholarly journals The effect of height and weight adjusted dose of intrathecal hyperbaric bupivacaine for elective caesarean section

2011 ◽  
Vol 51 (181) ◽  
Author(s):  
A Subedi ◽  
M Tripathi ◽  
BK Bhattarai ◽  
PK Gupta ◽  
K Pokharel ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anesthesia ◽  
Elective Caesarean Section ◽  
Onset Time ◽  
Distinct Advantage ◽  
Spinal Block ◽  
Hyperbaric Bupivacaine ◽  
Number Of Patients ◽  
Block Level ◽  
Adjusted Dose

Introduction: The study compared spinal anesthesia using intrathecal hyperbaric bupivacaine between height and weight adjusted dose and fi xed dose during caesarean section. Methods: A hundred parturients, who had given their consent and were scheduled for elective caesarean section under spinal anesthesia, were randomly assigned into two groups. We adjusted the intrathecal dose of heavy bupivacaine (0.5 %) according to the height and weight of patients (Group AD) from Harten’s dose chart developed from the Caucasian parturients and the fi xed dose (2.2 ml) was used in Group FD patients. Keeping the observer blinded to the study groups, the onset time to sensory block up to T5, haemodynamic changes, side effects, and fetal outcome were observed. Results: The median onset time of spinal block in Group FD was faster than in Group AD (6 min vs. 4 min; p = 0.01). The spinal block level extended above T3 level in a signifi cantly (p < 0.05) larger number of patients 12 (24 %) in Group FD than in one (2 %) patient in Group AD. A signifi cantly (p < 0.05) larger number of patients, 32, (64 %) in Group FD had hypotension than in 15 (30 %) patients in Group AD. The lowest recorded SAP (101 ± 6 mm Hg) in Group AD was higher than in Group FD (96 ± 6.7 mm Hg). Nausea and vomiting were more pronounced in Group FD patients. Conclusions: The bupivacaine dose was signifi cantly reduced on its dose adjustment for the body weight and height of patients for cesearean section. This adjusted-dose use suitably restricted spinal block level for cesarean section with a distinct advantage of less hypotension and with a similar neonatal outcome as fi xed compared with the dose use. keywords: caesarean section; low-dose hyperbaric bupivacaine; spinal anesthesia.

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