minidose bupivacaine – fentanyl spinal anesthesia for cesarean section in preeclamptic parturients
نویسندگان
چکیده
abstract background: spinal anesthesia for cesarean section is associated with a high incidence of hypotension. the synergism between intrathecal opioids and local anesthetics may make it possible to achieve reliable spinal anesthesia with minimal hypotension using a minidose of local anesthetic. methods: forty-four preeclamptic parturients undergoing cesarean section were randomized in two groups of 22 patients. group a received a spinal anesthetic of bupivacaine 6 mg plus fentanyl 20 µg , and group b received 12 mg bupivacaine. hypotension was defined as a 30% decrease in systolic and diastolic pressure from baseline. hypotension was treated with intravenous ephedrine boluses 2.5-5 mg up to maximum 50 mg. results: all patients had satisfactory anesthesia. five of 22 patients in group a required ephedrine, a single dose of 5 mg. seventeen of 22 patients in group b required vasopressor support of blood pressure. the lowest recorded systolic, diastolic and mean blood pressures as fractions of the baseline pressures were 71.2%, 64.5% and 70.3% versus 59.9%, 53.5% and 60.2% respectively for group a versus group b. conclusion: a “minidose” of 6 mg bupivacaine in combination with 20 µg fentanyl may provide satisfactory spinal anesthesia for cesarean section in the preeclamptic patient. the minidose combination caused dramatically less hypotension than 12 mg bupivacaine and nearly eliminated the need for vasopressor support of blood pressure.
منابع مشابه
MINIDOSE BUPIVACAINE – FENTANYL SPINAL ANESTHESIA FOR CESAREAN SECTION IN PREECLAMPTIC PARTURIENTS
ABSTRACT Background: Spinal anesthesia for cesarean section is associated with a high incidence of hypotension. The synergism between intrathecal opioids and local anesthetics may make it possible to achieve reliable spinal anesthesia with minimal hypotension using a minidose of local anesthetic. Methods: Forty-four preeclamptic parturients undergoing cesarean section were randomized in two gr...
متن کاملSpinal anesthesia with minidose bupivacaine-fentanyl for cesarean section in preeclamptic parturients.
متن کامل
Spinal Anesthesia in Preeclamptic Parturients
In this prospective cohort study, we compared the incidence and severity of spinal anesthesia (SA) associated hypotension in preeclamptics (n=25) versus healthy parturients (n=25) undergoing cesarean delivery. After proper preloading, SA was administered with 0.75% hyperbaric bupivacaine. Blood pressure (BP) was recorded before performing SA (baseline BP), and then after SA, every 2 minutes for...
متن کاملComparing the Hemodynamic Effects of Spinal Anesthesia in Preeclamptic and Healthy Parturients During Cesarean Section
BACKGROUND Despite controversies about the safest anesthetic technique for cesarean delivery in severely preeclamptic women, there is evidence that supports the use of spinal anesthesia in this group of patients. OBJECTIVES This prospective randomized clinical trial was designed to determine the hemodynamic effects of low-dose spinal bupivacaine and the incidence of spinal anesthesia-associat...
متن کاملSynergistic effect of intrathecal fentanyl and bupivacaine in spinal anesthesia for cesarean section
BACKGROUND: Potentiating the effect of intrathecal local anesthetics by addition of intrathecal opiods for intra-abdominal surgeries is known. In this study by addition of fentanyl we tried to minimize the dose of bupivacaine, thereby reducing the side effects caused by higher doses of intrathecal bupivacaine in cesarean section. METHODS: Study was performed on 120 cesarean section parturients ...
متن کاملIntrathecal fentanyl for prevention of shivering in spinal anesthesia in cesarean section
Background: Shivering is one of the common problems in spinal anesthesia. The objective of the present study was to evaluate the effect of intrathecal fentanyl (25 μg) on incidence and severity of intraoperative and postoperative shivering. Methods: A double-blind randomized controlled study was conducted in eighty healthy women (ASA Physical status I) scheduled for elective cesarean section u...
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عنوان ژورنال:
medical journal of islamic republic of iranجلد ۲۰، شماره ۲، صفحات ۹۴-۹۷
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