Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial
The optimal intrathecal dose of local anaesthetic for caesarean section (CS) anaesthesia is still being debated. We performed a study to compare the effectiveness and safety of spinal anaesthesia with 12.5 mg of hyperbaric bupivacaine and a dosing regimen of conventional doses adjusted to parturient...
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MDPI AG
2020-11-01
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| Series: | Journal of Clinical Medicine |
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| author | Katarzyna Białowolska Bartosz Horosz Agnieszka Sękowska Małgorzata Malec-Milewska |
| author_facet | Katarzyna Białowolska Bartosz Horosz Agnieszka Sękowska Małgorzata Malec-Milewska |
| author_sort | Katarzyna Białowolska |
| collection | DOAJ |
| description | The optimal intrathecal dose of local anaesthetic for caesarean section (CS) anaesthesia is still being debated. We performed a study to compare the effectiveness and safety of spinal anaesthesia with 12.5 mg of hyperbaric bupivacaine and a dosing regimen of conventional doses adjusted to parturient height. One hundred and forty parturients scheduled for elective CS were enrolled. The fixed-dose group (FD) received a spinal block with 12.5 mg of hyperbaric bupivacaine with fentanyl, whereas the adjusted-dose group (AD) received a height-adjusted dose of bupivacaine (9–13 mg) with fentanyl. Sensory block ≥ T5 dermatome within 10 min and no need for supplementary analgesia were set as the composite primary outcome (success). Rates of successful blocks and complications were compared. Complete data were available for 134 cases. Spinal anaesthesia was successful in 58 out of 67 patients in the FD group and 57 out of 67 in the AD group (<i>p</i> > 0.05). Eight spinals in each group failed to produce a block ≥ T5 in 10 min, and one patient in the FD group and two in the AD group required i.v. analgesics despite sensory block ≥ T5. No differences were noted in terms of hypotension, bradycardia and nausea between the FD and AD groups. Compared to the height-adjusted dose regimen based on conventional doses of hyperbaric bupivacaine, the fixed dose regimen of 12.5 mg was equally effective and did not increase the risk of spinal block-related complications. |
| first_indexed | 2024-03-10T15:00:34Z |
| format | Article |
| id | doaj.art-22ea0525db884e2682a168d194d9229b |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T15:00:34Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-22ea0525db884e2682a168d194d9229b2023-11-20T20:12:50ZengMDPI AGJournal of Clinical Medicine2077-03832020-11-01911360010.3390/jcm9113600Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised TrialKatarzyna Białowolska0Bartosz Horosz1Agnieszka Sękowska2Małgorzata Malec-Milewska3Department of Anaesthesiology and Intensive Care, Medical Centre of Postgraduate Education, Orlowski Hospital, Ul. Czerniakowska 231, 00-416 Warsaw, PolandDepartment of Anaesthesiology and Intensive Care, Medical Centre of Postgraduate Education, Orlowski Hospital, Ul. Czerniakowska 231, 00-416 Warsaw, Poland2nd Department of Obstetrics and Gynaecology, Medical Centre of Postgraduate Education, Bielanski Hospital, Ul. Cegłowska 80, 01-809 Warsaw, PolandDepartment of Anaesthesiology and Intensive Care, Medical Centre of Postgraduate Education, Orlowski Hospital, Ul. Czerniakowska 231, 00-416 Warsaw, PolandThe optimal intrathecal dose of local anaesthetic for caesarean section (CS) anaesthesia is still being debated. We performed a study to compare the effectiveness and safety of spinal anaesthesia with 12.5 mg of hyperbaric bupivacaine and a dosing regimen of conventional doses adjusted to parturient height. One hundred and forty parturients scheduled for elective CS were enrolled. The fixed-dose group (FD) received a spinal block with 12.5 mg of hyperbaric bupivacaine with fentanyl, whereas the adjusted-dose group (AD) received a height-adjusted dose of bupivacaine (9–13 mg) with fentanyl. Sensory block ≥ T5 dermatome within 10 min and no need for supplementary analgesia were set as the composite primary outcome (success). Rates of successful blocks and complications were compared. Complete data were available for 134 cases. Spinal anaesthesia was successful in 58 out of 67 patients in the FD group and 57 out of 67 in the AD group (<i>p</i> > 0.05). Eight spinals in each group failed to produce a block ≥ T5 in 10 min, and one patient in the FD group and two in the AD group required i.v. analgesics despite sensory block ≥ T5. No differences were noted in terms of hypotension, bradycardia and nausea between the FD and AD groups. Compared to the height-adjusted dose regimen based on conventional doses of hyperbaric bupivacaine, the fixed dose regimen of 12.5 mg was equally effective and did not increase the risk of spinal block-related complications.https://www.mdpi.com/2077-0383/9/11/3600elective caesareanspinal anaesthesiahyperbaric bupivacainehypotension |
| spellingShingle | Katarzyna Białowolska Bartosz Horosz Agnieszka Sękowska Małgorzata Malec-Milewska Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial Journal of Clinical Medicine elective caesarean spinal anaesthesia hyperbaric bupivacaine hypotension |
| title | Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial |
| title_full | Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial |
| title_fullStr | Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial |
| title_full_unstemmed | Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial |
| title_short | Fixed Dose versus Height-Adjusted Conventional Dose of Intrathecal Hyperbaric Bupivacaine for Caesarean Delivery: A Prospective, Double-Blinded Randomised Trial |
| title_sort | fixed dose versus height adjusted conventional dose of intrathecal hyperbaric bupivacaine for caesarean delivery a prospective double blinded randomised trial |
| topic | elective caesarean spinal anaesthesia hyperbaric bupivacaine hypotension |
| url | https://www.mdpi.com/2077-0383/9/11/3600 |
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