scholarly journals Minimal Effective Dose of Ropivacaine Under Spinal Anesthesia for Cesarean Section After Failed Vaginal Delivery by Epidural Labor Analgesia

2021 ◽  
Author(s):  
Rui Ma ◽  
Jianwei Wang ◽  
Yu Wei
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Labor Analgesia ◽  
Clinical Trial Registration ◽  
Minimal Effective Dose ◽  
Sequential Allocation ◽  
Low Incidence ◽  
Sequential Experiment ◽  
Effective Group

Abstract Background: The studies associated with EC50 of ropivacaine for spinal anesthesia are few worldwide during failed vaginal trial by epidural labor analgesia transfer to cesarean section. We preliminarily explore it to determine the minimum local analgesic dose (MLAD) of ropivacaine for spinal anesthesia during failed vaginal trial by epidural labor analgesia transfer to cesarean section(CS) and survey its adverse effect. Trial design: a sequential experimentMethods: The analgesia quality was defined as effective if VAS ( Visual Analogue Scale) score was less than 3 from 15 min after spinal anesthesia to the end of CS. The Brownlee up-and-down sequential allocation was used to estimate the MLAD of subarachnoid ropivacaine and its 95% confidence intervals during failed vaginal trial by epidural labor analgesia transfer to CS. Results: There were significant changes for the time to reach maximum sensory block, the time to reach maximum motor block and the duration from spinal anesthesia to starting operation and hypotension occurence (p＜0.05, p＜0.0001, respectively) between the effective group and ineffective group. Bradyarrhythmia, nausea, vomiting and chills were no significant changes between these two groups. The EC50 dose of f subarachnoid ropivacaine for failed vaginal trial conversion to CS by epidural labor analgesia was 8.2985 mg , and 95% CI( Confidence Interval) was 8.07947mg~8.52348mg.Conclusion: The MLAD of ropivacaine was 8.2985 mg ( 95% CI: 8.0795mg~ 8.5235mg) for spinal anesthesia for failed vaginal trial by epidural labor analgesia conversion to CS. It was indicated that 8.2985 mg ropivacaine by subarachnoid block for failed vaginal trial transfer to CS can provide satisfactory and safe analgesia to parturients with low incidence rate of side effects.Clinical Trial Registration: This clinical study has been registered at www.chictr.org.cn(ChiCTR1900027527).

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 Thoracic spinal anesthesia for cesarean section in severe pre-eclampsia: exploring a new dimension

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Rajeev Chauhan ◽  
Pranshuta Sabharwal ◽  
Rashi Sarna ◽  
Shyamcharan Meena
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Anesthetic Management ◽  
Sensory Block ◽  
Lumbar Region ◽  
Lower Segment ◽  
Hemodynamic Stability ◽  
Emergency Situations ◽  
Lower Segment Cesarean Section ◽  
Thoracic Spinal

Abstract Background Severe pre-eclampsia poses a dilemma for the anesthesiologist especially in emergency situations where cesarean deliveries are done for the un-investigated or partially investigated parturient. Hemodynamic stability is the major goal of anesthetic management of these patients. Thoracic spinal anesthesia has been successfully given for various surgeries like breast cancer and abdominal cancer but not for cesarean section. Case presentation We report a case of a 35-year-old at 33+5-week period of gestation with severe pre-eclampsia and bullous lesions managed successfully with segmental thoracic spinal anesthesia. General anesthesia in this patient could have been risky as the patient was not fasting; airway bullous lesions could not be ruled out and Mallampati grade was III on airway examination. Presence of lesions in lumbar region precluded the lumbar spinal technique. The technique was associated with an adequate level of the sensory block during lower segment cesarean section, a high degree of hemodynamic stability, and a high patient satisfaction Conclusion Segmental thoracic spinal anesthesia can be used successfully and effectively for lower segment cesarean section by experienced anesthetists. Further studies are warranted to compare its effect, especially on hemodynamics with known techniques.

scholarly journals Addition of low-dose sufentanil to ropivacaine for reducing shivering and visceral traction pain during cesarean section

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110170
Author(s):  
Xiao-Rong Chen ◽  
Tao Gao ◽  
Yin Zhang ◽  
Ming-Qing Peng
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Sensory Block ◽  
Controlled Study ◽  
Blood Oxygen Saturation ◽  
Time Duration ◽  
Significant Difference ◽  
Block Time ◽  
Time Motor

Objective To investigate the efficacy of low-dose sufentanil for preventing shivering and visceral traction pain during cesarean section under spinal anesthesia. Methods This was a prospective, randomized, controlled study. A total of 112 full-term parturients who underwent elective caesarean delivery were randomly divided into two groups. Group R received 0.75% isobaric ropivacaine intrathecally and group RS received 0.75% isobaric ropivacaine plus 5 µg sufentanil intrathecally. Results There were no significant differences in the maximum sensory block time, motor block time, duration of the surgery, and heart rate, mean arterial pressure, and blood oxygen saturation before and 1, 5, and 10 minutes after spinal anesthesia, and at the end of the surgery between the two groups. Shivering was significantly more common in group R (n = 30) than in group RS (n = 8). The incidence of visceral traction pain in group R (46.43%) was significantly higher than that in group RS (14.29%). There was no significant difference in the newborns’ Apgar scores between the groups. Conclusion Adding low-dose sufentanil to ropivacaine can significantly reduce the incidence of shivering and visceral traction pain after spinal anesthesia.

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.

Effectiveness of spinal anesthesia after epidural labor analgesia versus spinal anesthesia only for intrapartum cesarean section

2015 ◽  
Vol 10 (3) ◽  
pp. 203-207 ◽  
Author(s):  
Joo Yeon Jeon ◽  
Sang-Hwan Do ◽  
In-Ho Lee ◽  
Young Seok Jee ◽  
Seung-In Park ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Labor Analgesia
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