scholarly journals A randomized prospective study comparing conventional dose to low dose of hyperbaric bupivacaine for spinal anaesthesia in elective caesarean section

2020 ◽  
Vol 3 (2) ◽  
pp. 34-40
Author(s):  
Gurpartap Singh ◽  
Rohit Kumar Varshney ◽  
GS Jheetay ◽  
Nakul Srivastava
Keyword(s):  
Caesarean Section ◽  
Prospective Study ◽  
Spinal Anaesthesia ◽  
Low Dose ◽  
Elective Caesarean Section ◽  
Hyperbaric Bupivacaine ◽  
Conventional Dose

scholarly journals Low Dose Hyperbaric Bupivacaine and Dexmedetomidine as an Adjuvant in Spinal Anaesthesia, Caesarean Section: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Ahmed Ashraf Nasr ◽  
Safaa Mohamed Helal ◽  
Wesam Eldin Abdelrahman Soltan
Keyword(s):  
Caesarean Section ◽  
Postoperative Analgesia ◽  
Ordinal Data ◽  
Low Dose ◽  
Enhanced Recovery ◽  
Elective Caesarean Section ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Hyperbaric Bupivacaine

Abstract Background Alpha-2 agonist, e.g. dexmedetomidine, is a non-opioid adjuvant with a substantial role in extending the analgesic duration of the subarachnoid block. Here, we aim to test the efficacy of adding dexmedetomidine to hyperbaric bupivacaine in the caesarean delivery, targeting enhanced postoperative analgesia and more stable hemodynamics. Methods 40 parturient women scheduled for elective caesarean section were enrolled and randomly allocated to two groups. Low Dose – Dexmedetomidine (LD- DEX) group (n = 20) received 7 mg hyperbaric bupivacaine plus 10 µg dexmedetomidine, control group (n = 20) received 12 mg hyperbaric bupivacaine. Continuous normally distributed data were expressed as mean and standard deviation. Ordinal data and continuous data not fitting to the normal distribution curve were presented as medians (range) meanwhile categorical data were reported as percentage of the total number. Regarding the autonomic variables, we did a stratified analysis to compare the mean change of these variables every 3 minutes till 60 minutes through a two-sample t-test (Welch t-test). All statistical analyses were performed using R software version 3.4.4 Results LD- DEX groups showed significant faster and prolonged sensory block (P-value < 0.05), stable maternal hemodynamic maintained by less amount of IV fluids (P-value < 0.01), lower doses of ephedrine (P-value = 0.02), no signs of foetal distress, and low incidence of postoperative maternal shivering. As well, 3 hours cut off pain was more significant in LD- DEX group (P-value < 0.01). Conclusion LD- DEX group provided an optimum intraoperative condition and postoperative analgesia with less maternal side effects and no neonatal risks, encouraging enhanced recovery and less hospital in-stay.

Low dose hyperbaric bupivacaine and fentanyl for spinal anaesthesia in caesarean section

2018 ◽  
Vol 7 (1) ◽  
pp. 06-12
Author(s):  
S J Kulkarni ◽  
◽  
S O Ruhatiya ◽  
V P Kelkar ◽  
P P Nayak ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Low Dose ◽  
Hyperbaric Bupivacaine

scholarly journals Comparison of haemodynamic effects of lateral and sitting positions during induction of spinal anaesthesia for elective caesarean section

2017 ◽  
Vol 5 (3) ◽  
pp. 851 ◽  
Author(s):  
Nutan Dileeprao Kharge ◽  
Ashish Mali ◽  
Pinakin Gujjar
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Motor Block ◽  
Elective Caesarean Section ◽  
Lateral Position ◽  
Sensory Level ◽  
Sitting Position ◽  
Hemodynamic Parameters ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference

Background: Spinal anaesthesia avoids the problems associated with general anaesthesia such as airway manipulation, polypharmacy, postoperative respiratory problems, and cognitive dysfunction. It can be given in lateral and sitting positions. The aim of the present study was to compare the effect of induction position for spinal anaesthesia in elective caesarean section on hemodynamic, sensory and motor block characteristics and patient satisfaction.Methods: 120 ASA physical status I and II patients undergoing elective caesarean section were randomized to receive spinal anaesthesia in the lateral position or the sitting position. Hyperbaric bupivacaine (0.5%) was injected into the spinal space while the patients were either in sitting or lateral position at L3-L4 level. Effects on hemodynamic parameters, sensory block and motor block characteristics and patient satisfaction were analysed.Results: Demographic characteristics did not seem to have any impact on the overall outcome of the study. Induction position for spinal anaesthesia does not affect the hemodynamic parameters and incidence of side effects when adequate preloading is done. There was no statistically significant difference in the sensory level and motor level achieved. However lateral position appears to be more comfortable than sitting position (P <0.001).Conclusions: Inducing position for spinal anaesthesia did not affect haemodynamic stability and block characteristics in both the groups except that patients feel more comfortable in lateral position.

scholarly journals Subarachnoid clonidine or fentanyl with low dose hyperbaric bupivacaine for elective caesarean section - A comparative study

2012 ◽  
Vol 17 (1) ◽  
pp. 14-17
Author(s):  
Md Manowarul Islam ◽  
Nadeem Parvez Ali ◽  
Rabeya Begum ◽  
AKM Akhtaruzzaman
Keyword(s):  
Caesarean Section ◽  
Total Dose ◽  
Low Dose ◽  
Epigastric Pain ◽  
Elective Caesarean Section ◽  
Local Anaesthetics ◽  
Hyperbaric Bupivacaine ◽  
Subarachnoid Block ◽  
Parametric Data

Background: Preferred technique of anaesthesia for caesarean section is neuraxial block. Hyperbaric bupivacaine in adequate dose for subarachnoid block often causes complications like hypotension, shivering, nausea, vomiting, chest pain and epigastric pain. Objectives: The aim of study is to reduce the complications of subarachnoid block, improve quality of block, quality of anesthesia, prolong duration of post operative analgesia by reducing total dose of local anaesthetics with the use of adjuvant like fentanyl or clonidine. Methods: Ninety parturients of ASA grade I & II for caesarean section under subarachnoid block were randomly allocated equally into three groups: Group B: hyperbaric bupivacaine 0.5% of 2 ml+ 0.25ml normal saline regarded as controlGroup BC: hyperbaric bupivacaine 0.5% of 1.75 ml + 0.5 ml clonidine (75 ?g)Group BF: hyperbaric bupivacaine 0.5% of 1.75 ml + 0.5 ml fentanyl (25 ?g) Parametric data like pulse, blood pressure among the groups were analyzed by ANOVA test & nonparametric data like chest discomfort, epigastric pain, nausea, vomiting were analyzed by chi-square test. Results: The study revealed that subarachnoid clonidine or fentanyl as adjuvant with low dose hyperbaric bupivacaine provide better quality of block, better quality of anaesthesia,more haemodynamical stability and longer duration of post operative analgesia compared to bupivacaine alone.Clonidine is better alternative to fentanyl as adjuvant with bupivacine in subarachnoid block. Conclusion: Addition of clonidine as adjuvant can reduce total dose of bupivacaine in subarachnoid block to ensure better quality of block, better quality of anaesthesia by reducing complications and longer duration of post operative analgesia compared to fentanyl. DOI: http://dx.doi.org/10.3329/jdnmch.v17i1.12185 J. Dhaka National Med. Coll. Hos. 2011; 17 (01): 14-17

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