Efficacy of Intrathecal Injection Rate of Bupivacaine 0.5%
|
N. Manouchehrian (MD) * , F. Rahimi Bashar (MD) , M. Arab |
|
|
Abstract: (7928 Views) |
BACKGROUND AND
OBJECTIVE: Adequate
sensory block for cesarean section under spinal anesthesia is T4-T6 that
several factors (local anesthetic dose and baricity, position, rate of
injection …) correlate with block height. This study was designed to evaluate
the efficacy of intrathecal injection rate of bupivacaine
0.5% on sensory and motor block in cesarean section. METHODS: After confirmation of Ethic committee in this double blind
clinical trial study, 75 term parturients were evaluated. All of patients
underwent spinal anesthesia and allocated randomly to 3 groups (n=25) according
to intrathecal injection rate of 10 mg bupivacaine 0.5% and 2.5 μg sufentanil
and 0.5 ml normal saline in total volume of 3 ml. Patients received intrathecal
local anesthetic by injection rate of 1ml/sec or 3ml/3 sec in Fast group, 0.2 ml/sec
or 3ml/15 sec in Moderate group and 0.04 ml/sec or 3ml/75 sec in Slow group.
Immediately sensory and motor block level were determined every 1 minute by
Pinprick and Bromage score respectively. Blood pressure and heart rate was
measured regularly, and nausea, vomiting and ephedrine dose was recorded.
(IRCT=IRCT2012122210841N2 ) FINDINGS: Our
study demonstrated that sensory level in Fast, Moderate and Slow groups was
respectively T4, T5 and T6 that significantly was higher in Fast group. Timing
of sensory block in Fast group was 3±0.4 and in Moderate and Slow groups were
4.4±0.7 and 4.2±0.4 minutes respectively (p<0.001). Fast injection of spinal
anesthetic significantly increases prevalence of hypotension and reducing time
of sensory level to T10 in cesarean delivery (F=114.8±14.4, M=81.6±7 and
S=74±18.3 minutes, p<0.001). Incidence of nausea and vomiting in Fast group
was 76% and 48% whereas in Moderate was 16% and 8% and in Slow group was 20%
and 8% (p<0.001). CONCLUSION: We
concluded that fast intrathecal injection of bupivacaine increases sensory and
motor block and hypotension, nausea and vomiting in cesarean section. |
|
Keywords: Anesthesia, Spinal, Bupivacaine, Cesarean section, Hypotension, Sensory block |
|
Full-Text [PDF 556 kb]
(1881 Downloads)
|
Type of Study: Research |
Subject:
Histology Received: 2013/10/23 | Accepted: 2014/03/6 | Published: 2014/08/26
|
|
|
|