A Prospective, Randomized, Double-Blind Comparison of Unilateral Spinal Anesthesia with Hyperbaric Bupivacaine, Ropivacaine, or Levobupivacaine for Inguinal Herniorrhaphy

Latar Belakang: Anestesi spinal mempunyai efek samping berupa hipotensi dan mual muntah. Tujuan: penelitian ini adalah membandingkan efek anestesi spinal bupivacain dosis normal 12,5 mg dan bupivacain dosis rendah 5 mg dengan fentanyl 50 mg pada seksio sesarea terhadap perubahan hemodinamik, ketinggian blok, onset, durasi dan efek samping. Subjek dan Metode: Penelitian double blind randomized control trial pada 36 pasien yang memenuhi kriteria. Pasien dibagi menjadi dua kelompok, yang masing-masing terdiri 18 pasien, kelompok 1 dilakukan anestesi spinal dengan bupivacain hiperbarik 5 mg ditambah adjuvan fentanyl 50 mcg, sedangkan kelompok 2 diberikan bupivacain hiperbarik 12,5 mg. Penilaian meliputi saat mula kerja blokade sensorik, mula kerja blokade motorik, durasi, tekanan darah, laju nadi, dan saturasi oksigen, lama kerja dan efek samping. Data hasil penelitian diuji secara statistik dengan uji chi-square. Hasil: Terdapat perbedaan signifikan pada onset dan durasi blokade sensorik dan motorik, bupivacain 12,5 mg lebih baik dibandingkan bupivacain 5 mg + fentanyl 50 mcg (p<0.05). Tidak ada perbedaan signifikan pada perubahan tanda vital dan efek samping (p>0.05). Simpulan: Bupivacain 12,5 mg menghasilkan onset lebih cepat dan durasi lebih lama dibandingkan bupivacain 5 mg + fentanil 50 mcg pada anestesi spinal untuk seksio sesarea Comparison of The Effectiveness Spinal Anesthesia with Bupivacaine 12,5 Mg and Bupivacaine 5 Mg added Fentanyl 50 Mcg in Caesarean Section Abstract Background: Spinal anesthesia has side effects such as hypotension and nausea and vomiting. Objective: The aim of this study was to compare the effects of spinal anesthesia with normal doses of 12,5 mg of bupivacaine and 5 mg of low-dose bupivacaine with fentanyl 50 mg in the cesarean section on hemodynamic changes, block height, onset, duration, and side effects. Subjects and Methods: Double-blind randomized control trial in 36 patients who met the criteria. Patients were divided into two groups, each consisting of 18 patients, group 1 underwent spinal anesthesia with 5 mg of hyperbaric bupivacaine plus 50 mcg of fentanyl adjuvant, while group 2 was given 12,5 mg of hyperbaric bupivacaine. Assessments include the initiation of sensory block action, onset of motor block action, duration, blood pressure, pulse rate, and oxygen saturation, duration of action, and side effects. The research data were statistically tested with the chi-square test. Results: There were significant differences in the onset and duration of sensory and motor blockade, bupivacaine 12,5 mg was better than bupivacaine 5 mg + fentanyl 50 mcg (p <0.05). There was no significant difference in changes in vital signs and side effects (p> 0.05). Conclusion: Bupivacaine 12,5 mg resulted in a faster onset and longer duration than bupivacaine 5 mg + fentanyl 50 mcg in spinal anesthesia for cesarean section.

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INTRATHECAL 1% 2 CHLOROPROCAINE V/S 0.5% HYPERBARIC BUPIVACAINE IN AMBULATORY SURGERY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i8.2103 ◽

2021 ◽

Vol 5 (8) ◽

Author(s):

Mukesh Choudhary ◽

Abhimanyu Singh

Keyword(s):

Spinal Anesthesia ◽

Hospital Discharge ◽

Ambulatory Surgery ◽

Sensory Block ◽

Ambulatory Setting ◽

Interventional Study ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Subarachnoid Block

Background: Aims of the study to compare 2-CP with bupivacaine for spinal anesthesia in an elective ambulatory setting. Methods: Hospital based Randomized, Double Blind, Interventional study conducted on patients undergoing for ambulatory surgery under subarachnoid block. Results: The finding that shows the most significant advantage is the time for regression of the sensory block to S2, as 2-CP was faster than bupivacaine. Conclusion: 2-chloroprocaine provides adequate duration and depth of surgical anesthesia for short procedures with the advantages of faster block resolution and earlier hospital discharge compared with spinal bupivacaine Keywords: 2-chloroprocaine, Bupivacaine, Ambulatory surgery

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How Long Should a Patient Stay in Lateral Position for Unilateral Spinal Anesthesia with Hyperbaric Bupivacaine?

Korean Journal of Anesthesiology ◽

10.4097/kjae.2000.38.1.35 ◽

2000 ◽

Vol 38 (1) ◽

pp. 35 ◽

Cited By ~ 1

Author(s):

Seong Hoon Ko ◽

Seung Gwan Kang ◽

Sang Kyi Lee ◽

Young Jin Han ◽

Huhn Choe ◽

...

Keyword(s):

Spinal Anesthesia ◽

Lateral Position ◽

Hyperbaric Bupivacaine ◽

Unilateral Spinal Anesthesia ◽

Patient Stay

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Phenylephrine Added to Prophylactic Ephedrine Infusion during Spinal Anesthesia for Elective Cesarean Section

Anesthesiology ◽

10.1097/00000542-200109000-00020 ◽

2001 ◽

Vol 95 (3) ◽

pp. 668-674 ◽

Cited By ~ 99

Author(s):

Frédéric J. Mercier ◽

Edward T. Riley ◽

Willard L. Frederickson ◽

Sandrine Roger-Christoph ◽

Dan Benhamou ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Spinal Anesthesia ◽

Cesarean Delivery ◽

Elective Cesarean Section ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Elective Cesarean ◽

American Society ◽

Spinal Hypotension

Background Because ephedrine infusion (2 mg/min) does not adequately prevent spinal hypotension during cesarean delivery, the authors investigated whether adding phenylephrine would improve its efficacy. Methods Thirty-nine parturients with American Society of Anesthesiologists physical status I-II who were scheduled for cesarean delivery received a crystalloid preload of 15 ml/kg. Spinal anesthesia was performed using 11 mg hyperbaric bupivacaine, 2.5 microg sufentanil, and 0.1 mg morphine. Maternal heart rate and systolic blood pressure were measured at frequent intervals. A vasopressor infusion was started immediately after spinal injection of either 2 mg/min ephedrine plus 10 microg/min phenylephrine or 2 mg/min ephedrine alone. Treatments were assigned randomly in a double-blind fashion. The infusion rate was adjusted according to systolic blood pressure using a predefined algorithm. Hypotension, defined as systolic blood pressure less than 100 mmHg and less than 80% of baseline, was treated with 6 mg ephedrine bolus doses. Results Hypotension occurred less frequently in the ephedrine-phenylephrine group than in the ephedrine-alone group: 37% versus 75% (P = 0.02). Ephedrine (36+/-16 mg, mean +/- SD) plus 178+/-81 microg phenylephrine was infused in former group, whereas 54+/-18 mg ephedrine was infused in the latter. Median supplemental ephedrine requirements and nausea scores (0-3) were less in the ephedrine-phenylephrine group (0 vs. 12 mg, P = 0.02; and 0 vs. 1.5, P = 0.01, respectively). Umbilical artery pH values were significantly higher in the ephedrine-phenylephrine group than in the group that received ephedrine alone (7.24 vs. 7.19). Apgar scores were similarly good in both groups. Conclusion Phenylephrine added to an infusion of ephedrine halved the incidence of hypotension and increased umbilical cord pH.

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Dexamethasone blunts postspinal hypotension in geriatric patients undergoing orthopedic surgery: a double blind, placebo-controlled study

BMC Anesthesiology ◽

10.1186/s12871-021-01232-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tarek M. Ashoor ◽

Noha S. Hussien ◽

Sherif G. Anis ◽

Ibrahim M. Esmat

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Elderly Patients ◽

Spinal Anesthesia ◽

Demographic Data ◽

Volume Overload ◽

Controlled Study ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Link Type

Abstract Background Post-spinal anesthesia (PSA) hypotension in elderly patients is challenging. Correction of PSA hypotension by fluids either colloids or crystalloids or by vasoconstrictors pose the risk of volume overload or compromising cardiac conditions. Dexamethasone is used to treat conditions manifested by decrease of peripheral vascular resistance. The research team was the first to test the hypothesis of its role in preventing or decreasing the incidence of PSA hypotension. Methods One hundred ten patients, aged 60 years or more were recruited to receive a single preoperative dose of dexamethasone 8 mg IVI in 100 ml normal saline (D group) (55 patients) 2 h preoperatively, and 55 patients were given placebo (C group) in a randomized, double-blind trial. Variations in blood pressure and heart rate in addition to the needs of ephedrine and/or atropine following spinal anesthesia (SA) were recorded. SA was achieved using subarachnoid injection of 3 ml hyperbaric bupivacaine 0.5%. Results Demographic data and the quality of sensory and motor block were comparable between groups. At 5th, 10th minutes post SA; systolic, diastolic and mean arterial pressures were statistically significant higher in D group. At 20th minutes post SA; the obtained blood pressure readings and heart rate changes didn’t show any statistically significance between groups. The need for ephedrine and side effects were statistically significant lower in D group than C group. Conclusion Post-spinal anesthesia hypotension, nausea, vomiting and shivering in elderly patients were less common after receiving a single preoperative dose of dexamethasone 8 mg IVI than control. Registration number ClinicalTrials.gov Identifier: NCT 03664037, Registered 17 September 2018 - Retrospectively registered, http://www.ClinicalTrial.gov

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Low-dose (5 mg) hyperbaric bupivacaine for unilateral spinal anesthesia in arthroscopic knee surgeries

EMERGENCY MEDICINE ◽

10.22141/2224-0586.1.96.2019.158755 ◽

2019 ◽

Vol 0 (1.96) ◽

pp. 107-112

Author(s):

A.G. Tutunnyk ◽

G.V. Panchenko ◽

A.V. Tsarev

Keyword(s):

Spinal Anesthesia ◽

Low Dose ◽

Hyperbaric Bupivacaine ◽

Unilateral Spinal Anesthesia ◽

Arthroscopic Knee

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Dexamethasone Blunts Post-Spinal Hypotension in Geriatric Patients Undergoing Orthopedic Surgery: A Double Blind, Placebo-Controlled Study

10.21203/rs.3.rs-54037/v1 ◽

2020 ◽

Author(s):

Tarek Ashoor ◽

Noha S. Hussien ◽

Sherif G. Anis ◽

Ibrahim M. Esmat

Keyword(s):

Heart Rate ◽

Spinal Anesthesia ◽

Demographic Data ◽

Volume Overload ◽

Controlled Study ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Spinal Hypotension ◽

Group D

Abstract Background. Post-spinal hypotension in elderly is challenging, correction by fluids either colloids or crystalloids or by vasoconstrictors pose the risk of volume overload or compromising cardiac conditions. Dexamethasone is used to treat conditions manifested by decrease of peripheral vascular resistance; we were the first to test the hypothesis of its role in preventing or decreasing the incidence of post-spinal hypotension.Methods. 110 patients aged 60 years or more were recruited in the study, 55 in the Dexamethasone group (D group) were given 8 mg Dexamethasone 2 hours preoperatively, and 55 were given placebo (C group).Variations in blood pressure and heart rate and need of vasoconstrictors and/or atropine following spinal anesthesia (SA) was done. SA was done by subarachnoid injection of 3 ml of hyperbaric bupivacaine.Results. Demographic data and the quality of sensory and motor block were comparable between groups. At 5, 10 minutes; systolic, diastolic and, mean arterial pressures were significantly higher in group D. At 20 minutes readings were non significant between groups. Heart rate changes didn’t show any significance. Need for ephedrine was less in group D, side effects were less in the D group. Conclusion. Dexamethasone may attenuate post-spinal hypotension in elderly, with a favorable response against nausea, vomiting and shivering that associate spinal anesthesia.

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Comparison of dexmedetomidine and buprenorphine as an adjuvant to bupivacaine during spinal anaesthesia for tibial interlocking nailing surgeries

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20175184 ◽

2017 ◽

Vol 4 (6) ◽

pp. 1653

Author(s):

Amitha S. ◽

Pradeep R.

Keyword(s):

Spinal Anesthesia ◽

Spinal Anaesthesia ◽

Motor Blockade ◽

Hyperbaric Bupivacaine ◽

Chi Square ◽

Double Blind ◽

Sensory Blockade ◽

Exact Test ◽

Interlocking Nailing ◽

Group 3

Background: Buprenorphine is being used as an adjuvant to local anaesthetic for spinal anaesthesia since long. Dexmedetomidine is a new drug which has got alpha 2 agonistic property, and is being tried for spinal anesthesia along with bupivacaine in recent times. Settings and Design: This study was conducted in a prospective, randomized, controlled and double-blind manner. The study included ninety American Society of Anaesthesiologists class I and II patients undergoing tibial interlocking nailing surgeries under spinal anaesthesia.Methods: The patients were randomly divided into three groups (n=30 each) by closed envelope technique. Patients in group 1 received 15 mg of 0.5% hyperbaric bupivacaine, group 2 received 15 mg of 0.5% hyperbaric bupivacaine with 30μg of buprenorphine, and group 3 received 15 mg of 0.5% hyperbaric bupivacaine with 5μg dexmedetomidine for spinal anesthesia. The duration of motor and sensory blockade and any adverse events were recorded. Data were analysed using Chi-square test or Fisher’s exact test for categorical data and analysis of variance for continuous data. A value of P<0.05 was considered as statistically significant.Results: In our study the subjects in group 3 (dexmedetomidine) group had significantly longer period of motor blockade (240±20min) and sensory blockade (180±22.2min) compared to other groups, which is statistically significant (P=0.0001 and P= 0.006 respectively). The time to first request of analgesic in the post-operative period was also longer (240±30.2min) in dexmedetomidine group when compared with other groups (P=0.0001). There were no untoward complications (hypotension, sedation) in any groups.Conclusions: We concluded that dexmedetomidine (5μg) with bupivacaine for spinal anesthesia gives significantly longer duration of sensory and motor blockade, than buprenorphine (30μg) with bupivacaine for spinal anaesthesia.

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