Minimum effective volume of bupivacaine in spinal anesthesia for elective cesarean section. Does it differ with height? A non-randomized parallel study

Background: Spinal anesthesia is the preferred anesthetic technique for elective Cesarean deliveries. Hypotension is the most common side-effect and has both maternal and neonatal consequences. This study aims to determine the minimum effective volume of hyperbaric bupivacaine 0.5% with fentanyl in...

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Main Authors: Walid Hamed Nofal, Wail Ahmed Abdelaal, Sanaa M. Elfawal
Format: Article
Language:English
Published: Taylor & Francis Group 2017-01-01
Series:Egyptian Journal of Anaesthesia
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1110184916301155
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author Walid Hamed Nofal
Wail Ahmed Abdelaal
Sanaa M. Elfawal
author_facet Walid Hamed Nofal
Wail Ahmed Abdelaal
Sanaa M. Elfawal
author_sort Walid Hamed Nofal
collection DOAJ
description Background: Spinal anesthesia is the preferred anesthetic technique for elective Cesarean deliveries. Hypotension is the most common side-effect and has both maternal and neonatal consequences. This study aims to determine the minimum effective volume of hyperbaric bupivacaine 0.5% with fentanyl in 90% of parturients (MEV90) with different height groups undergoing cesarean section. Patients and Methods: Parturients scheduled for elective cesarean section under spinal anesthesia were divided into 3 groups according to their height (ht), group 1 including those with height between 150 and 159 cm, group 2 with ht between 160 and 169 cm and group 3 patients with ht between 170 and 179 cm. The starting volumes were 2.5, 2.6 and 2.7 ml respectively. We identified 3 responses to the injected volume and the volume given to each parturient depends on the response of the previous one. Every patient was assessed for hemodynamics, degree of sensory and motor blocks. Results: Demographically, all the groups were comparable. The study was completed after recruiting 201 patients. The MEV90 for group 1 was approximately 2.62 ml (95% CI, 2.59–2.65 ml), 2.76 ml for group 2 (95% CI, 2.73–2.77 ml) and 2.80 for group 3 (95% CI, 2.76–2.81 ml). None of the babies had an Apgar score below 7 at 1 and 5 min after birth in the 3 groups. Conclusion: The volumes of hyperbaric 0.5% bupivacaine with fentanyl which produced effective spinal block in 90% of parturients undergoing cesarean deliveries were 2.62, 2.76 and 2.8 ml in the 3 different height groups respectively.
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spelling doaj.art-8462a487ab694023b475a322e11898842022-12-22T00:35:43ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492017-01-01331677210.1016/j.egja.2016.10.008Minimum effective volume of bupivacaine in spinal anesthesia for elective cesarean section. Does it differ with height? A non-randomized parallel studyWalid Hamed NofalWail Ahmed AbdelaalSanaa M. ElfawalBackground: Spinal anesthesia is the preferred anesthetic technique for elective Cesarean deliveries. Hypotension is the most common side-effect and has both maternal and neonatal consequences. This study aims to determine the minimum effective volume of hyperbaric bupivacaine 0.5% with fentanyl in 90% of parturients (MEV90) with different height groups undergoing cesarean section. Patients and Methods: Parturients scheduled for elective cesarean section under spinal anesthesia were divided into 3 groups according to their height (ht), group 1 including those with height between 150 and 159 cm, group 2 with ht between 160 and 169 cm and group 3 patients with ht between 170 and 179 cm. The starting volumes were 2.5, 2.6 and 2.7 ml respectively. We identified 3 responses to the injected volume and the volume given to each parturient depends on the response of the previous one. Every patient was assessed for hemodynamics, degree of sensory and motor blocks. Results: Demographically, all the groups were comparable. The study was completed after recruiting 201 patients. The MEV90 for group 1 was approximately 2.62 ml (95% CI, 2.59–2.65 ml), 2.76 ml for group 2 (95% CI, 2.73–2.77 ml) and 2.80 for group 3 (95% CI, 2.76–2.81 ml). None of the babies had an Apgar score below 7 at 1 and 5 min after birth in the 3 groups. Conclusion: The volumes of hyperbaric 0.5% bupivacaine with fentanyl which produced effective spinal block in 90% of parturients undergoing cesarean deliveries were 2.62, 2.76 and 2.8 ml in the 3 different height groups respectively.http://www.sciencedirect.com/science/article/pii/S1110184916301155Spinal anesthesiaCesarean sectionMinimum effective volumeHeight
spellingShingle Walid Hamed Nofal
Wail Ahmed Abdelaal
Sanaa M. Elfawal
Minimum effective volume of bupivacaine in spinal anesthesia for elective cesarean section. Does it differ with height? A non-randomized parallel study
Egyptian Journal of Anaesthesia
Spinal anesthesia
Cesarean section
Minimum effective volume
Height
title Minimum effective volume of bupivacaine in spinal anesthesia for elective cesarean section. Does it differ with height? A non-randomized parallel study
title_full Minimum effective volume of bupivacaine in spinal anesthesia for elective cesarean section. Does it differ with height? A non-randomized parallel study
title_fullStr Minimum effective volume of bupivacaine in spinal anesthesia for elective cesarean section. Does it differ with height? A non-randomized parallel study
title_full_unstemmed Minimum effective volume of bupivacaine in spinal anesthesia for elective cesarean section. Does it differ with height? A non-randomized parallel study
title_short Minimum effective volume of bupivacaine in spinal anesthesia for elective cesarean section. Does it differ with height? A non-randomized parallel study
title_sort minimum effective volume of bupivacaine in spinal anesthesia for elective cesarean section does it differ with height a non randomized parallel study
topic Spinal anesthesia
Cesarean section
Minimum effective volume
Height
url http://www.sciencedirect.com/science/article/pii/S1110184916301155
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