Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial

BackgroundSpinal anesthesia (SPA) is the most common type of anesthesia administered for cesarean section. The main aim of this study was to evaluate the effect of aspiration of CSF (0.2 mL) immediately after SPA with hyperbaric 0.5% bupivacaine on the extent of sensory and motor block.MethodsIn thi...

Full description

Bibliographic Details
Main Authors: Nahid Manouchehrian, Zahra Miri, Farzaneh Esna-Ashari, Farshid Rahimi-Bashar
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-03-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2022.816974/full
_version_ 1830229942043934720
author Nahid Manouchehrian
Zahra Miri
Farzaneh Esna-Ashari
Farshid Rahimi-Bashar
author_facet Nahid Manouchehrian
Zahra Miri
Farzaneh Esna-Ashari
Farshid Rahimi-Bashar
author_sort Nahid Manouchehrian
collection DOAJ
description BackgroundSpinal anesthesia (SPA) is the most common type of anesthesia administered for cesarean section. The main aim of this study was to evaluate the effect of aspiration of CSF (0.2 mL) immediately after SPA with hyperbaric 0.5% bupivacaine on the extent of sensory and motor block.MethodsIn this clinical trial, 60 women at ≥37 weeks of gestation and aged between 18 and 46 years, candidate for cesarean delivery under spinal anesthesia were randomly allocated into two equal groups (n = 30). Group A (CSF-aspiration group) received the spinal anesthesia with 10 mg of hyperbaric 0.5% bupivacaine with aspiration of 0.2 ml of CSF. Group B (no-CSF-aspiration group) received only 10 mg of 0.5% hyperbaric bupivacaine. Pin-prick analgesia and motor block were tested during the induction.ResultsThe mean maximum level of analgesia was T6 in each group. Although the mean time to reach the maximum level of anesthesia (4.43 ± 5.14 vs. 2.76 ± 2.04, P = 0.107) and to reach T10 level (50.56 ± 11.51 vs. 49.10 ± 13.68, P = 0.665) in the CSF-aspiration group is longer than the non-CSF-aspiration group, but this differences were not significant. There were no significant between-group differences regarding sensory and motor block quality (P = 0.389) or failed SPA (four cases in CSF-aspiration group vs. two cases in no-CSF-aspiration group, P = 0.389). The incidence of bradycardia, hypotension, headache, vomiting and nausea were similar in both groups (P > 0.05). In addition, the difference in hemodynamic parameters between the two groups over times was not statistically significant.ConclusionOur finding indicated that the aspiration of 0.2 ml of CSF after injection of spinal anesthesia with hyperbaric 0.5% bupivacaine does not seem to affect the extent of sensory and motor block, success rate, or outcome after SPA in cesarean section.Clinical Trial Registration[https://www.irct.ir/search/result?query=IRCT20120915010841N25], identifier [IRCT20120915010841N25].
first_indexed 2024-12-18T10:45:13Z
format Article
id doaj.art-8b40f8a355cc47d68075f640fd826a87
institution Directory Open Access Journal
issn 2296-858X
language English
last_indexed 2024-12-18T10:45:13Z
publishDate 2022-03-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Medicine
spelling doaj.art-8b40f8a355cc47d68075f640fd826a872022-12-21T21:10:33ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-03-01910.3389/fmed.2022.816974816974Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical TrialNahid Manouchehrian0Zahra Miri1Farzaneh Esna-Ashari2Farshid Rahimi-Bashar3Anesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, IranAnesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, IranDepartment of Family and Community Medicine, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IranAnesthesia and Critical Care Department, Hamadan University of Medical Sciences, Hamadan, IranBackgroundSpinal anesthesia (SPA) is the most common type of anesthesia administered for cesarean section. The main aim of this study was to evaluate the effect of aspiration of CSF (0.2 mL) immediately after SPA with hyperbaric 0.5% bupivacaine on the extent of sensory and motor block.MethodsIn this clinical trial, 60 women at ≥37 weeks of gestation and aged between 18 and 46 years, candidate for cesarean delivery under spinal anesthesia were randomly allocated into two equal groups (n = 30). Group A (CSF-aspiration group) received the spinal anesthesia with 10 mg of hyperbaric 0.5% bupivacaine with aspiration of 0.2 ml of CSF. Group B (no-CSF-aspiration group) received only 10 mg of 0.5% hyperbaric bupivacaine. Pin-prick analgesia and motor block were tested during the induction.ResultsThe mean maximum level of analgesia was T6 in each group. Although the mean time to reach the maximum level of anesthesia (4.43 ± 5.14 vs. 2.76 ± 2.04, P = 0.107) and to reach T10 level (50.56 ± 11.51 vs. 49.10 ± 13.68, P = 0.665) in the CSF-aspiration group is longer than the non-CSF-aspiration group, but this differences were not significant. There were no significant between-group differences regarding sensory and motor block quality (P = 0.389) or failed SPA (four cases in CSF-aspiration group vs. two cases in no-CSF-aspiration group, P = 0.389). The incidence of bradycardia, hypotension, headache, vomiting and nausea were similar in both groups (P > 0.05). In addition, the difference in hemodynamic parameters between the two groups over times was not statistically significant.ConclusionOur finding indicated that the aspiration of 0.2 ml of CSF after injection of spinal anesthesia with hyperbaric 0.5% bupivacaine does not seem to affect the extent of sensory and motor block, success rate, or outcome after SPA in cesarean section.Clinical Trial Registration[https://www.irct.ir/search/result?query=IRCT20120915010841N25], identifier [IRCT20120915010841N25].https://www.frontiersin.org/articles/10.3389/fmed.2022.816974/fullcerebrospinal fluidspinal anesthesiasensory blockmotor blockcesarean section
spellingShingle Nahid Manouchehrian
Zahra Miri
Farzaneh Esna-Ashari
Farshid Rahimi-Bashar
Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
Frontiers in Medicine
cerebrospinal fluid
spinal anesthesia
sensory block
motor block
cesarean section
title Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_full Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_fullStr Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_full_unstemmed Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_short Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_sort evaluation effect of aspiration of 0 2 ml of cerebrospinal fluid after completion of injection 0 5 bupivacaine and reinjection into subarachnoid space on sensory and motor block in cesarean section a randomized clinical trial
topic cerebrospinal fluid
spinal anesthesia
sensory block
motor block
cesarean section
url https://www.frontiersin.org/articles/10.3389/fmed.2022.816974/full
work_keys_str_mv AT nahidmanouchehrian evaluationeffectofaspirationof02mlofcerebrospinalfluidaftercompletionofinjection05bupivacaineandreinjectionintosubarachnoidspaceonsensoryandmotorblockincesareansectionarandomizedclinicaltrial
AT zahramiri evaluationeffectofaspirationof02mlofcerebrospinalfluidaftercompletionofinjection05bupivacaineandreinjectionintosubarachnoidspaceonsensoryandmotorblockincesareansectionarandomizedclinicaltrial
AT farzanehesnaashari evaluationeffectofaspirationof02mlofcerebrospinalfluidaftercompletionofinjection05bupivacaineandreinjectionintosubarachnoidspaceonsensoryandmotorblockincesareansectionarandomizedclinicaltrial
AT farshidrahimibashar evaluationeffectofaspirationof02mlofcerebrospinalfluidaftercompletionofinjection05bupivacaineandreinjectionintosubarachnoidspaceonsensoryandmotorblockincesareansectionarandomizedclinicaltrial