Adequate Anesthesia and More Effective Analgesia by Adjusted Doses of Bupivacaine during Cesarean Section: A Randomized Double-blind Clinical Trial
Background: Several adjuvants, added to local anesthetics, were suggested to induce an ideal regional block with high-quality analgesia. The purpose of this study was to evaluate the particular blocking properties of low-dose bupivacaine in combination with meperidine and fentanyl in spinal anesthes...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Shiraz University of Medical Sciences
2023-07-01
|
| Series: | Iranian Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://ijms.sums.ac.ir/article_48989_7bcfb2f91989a8e089eed8302a01cb74.pdf |
| _version_ | 1797782646975102976 |
|---|---|
| author | Zeinabsadat Fattahi-Saravi Vida Naderi-Boldaji Azadeh Azizollahi Simin Azemati Naeimehossadat Asmarian Mohammad-Bagher Khosravi |
| author_facet | Zeinabsadat Fattahi-Saravi Vida Naderi-Boldaji Azadeh Azizollahi Simin Azemati Naeimehossadat Asmarian Mohammad-Bagher Khosravi |
| author_sort | Zeinabsadat Fattahi-Saravi |
| collection | DOAJ |
| description | Background: Several adjuvants, added to local anesthetics, were suggested to induce an ideal regional block with high-quality analgesia. The purpose of this study was to evaluate the particular blocking properties of low-dose bupivacaine in combination with meperidine and fentanyl in spinal anesthesia during Cesarean sections.Methods: A randomized, double-blind clinical trial was conducted at Hafez Hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) from February 2015 to February 2016. A total of 120 pregnant women, who underwent spinal anesthesia during elective Cesarean section were enrolled in the study. Based on block-wise randomization, the patients were randomly assigned to three groups, namely “B” group received 2 mL bupivacaine 0.5% (10 mg), “BM” group received 8 mg bupivacaine and 10 mg meperidine, and “BF” group received 8 mg bupivacaine and 15 µg fentanyl intrathecally. The block onset, the duration of analgesia, and the time of discharge from the post-anesthesia care unit (PACU) were all assessed. Data were analyzed using SPSS software version 21, and P<0.05 were considered statistically significant.Results: The mean duration of motor blocks in the B group (150 min) were significantly higher than the BM (102 min) and BF (105 min) groups (P<0.0001). In both the BM and BF groups, the duration of sensory and motor blocks was the same. The length of stay in the PACU was significantly longer in the B group (P<0.001) than the BM and BF groups. When meperidine or fentanyl was added to bupivacaine, the duration of the analgesia lengthened (P<0.001). Conclusion: Intrathecal low-dose spinal anesthesia induced by bupivacaine (8 mg) in combination with meperidine and/or fentanyl for Cesarean section increased maternal hemodynamic stability, while ensuring effective anesthetic conditions, extending effective analgesia, and reducing the length of stay in PACU.Trial Registration Number: IRCT2015013119470N14. |
| first_indexed | 2024-03-13T00:13:54Z |
| format | Article |
| id | doaj.art-cbc0088f74e94ed08140bf212f5b63ba |
| institution | Directory Open Access Journal |
| issn | 0253-0716 1735-3688 |
| language | English |
| last_indexed | 2024-03-13T00:13:54Z |
| publishDate | 2023-07-01 |
| publisher | Shiraz University of Medical Sciences |
| record_format | Article |
| series | Iranian Journal of Medical Sciences |
| spelling | doaj.art-cbc0088f74e94ed08140bf212f5b63ba2023-07-12T04:19:55ZengShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-07161735-36882023-07-0148439340010.30476/ijms.2022.95205.265348989Adequate Anesthesia and More Effective Analgesia by Adjusted Doses of Bupivacaine during Cesarean Section: A Randomized Double-blind Clinical TrialZeinabsadat Fattahi-Saravi0Vida Naderi-Boldaji1Azadeh Azizollahi2Simin Azemati3Naeimehossadat Asmarian4Mohammad-Bagher Khosravi5Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, IranAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, IranAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, IranAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, IranAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, IranAnesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, IranBackground: Several adjuvants, added to local anesthetics, were suggested to induce an ideal regional block with high-quality analgesia. The purpose of this study was to evaluate the particular blocking properties of low-dose bupivacaine in combination with meperidine and fentanyl in spinal anesthesia during Cesarean sections.Methods: A randomized, double-blind clinical trial was conducted at Hafez Hospital affiliated with Shiraz University of Medical Sciences (Shiraz, Iran) from February 2015 to February 2016. A total of 120 pregnant women, who underwent spinal anesthesia during elective Cesarean section were enrolled in the study. Based on block-wise randomization, the patients were randomly assigned to three groups, namely “B” group received 2 mL bupivacaine 0.5% (10 mg), “BM” group received 8 mg bupivacaine and 10 mg meperidine, and “BF” group received 8 mg bupivacaine and 15 µg fentanyl intrathecally. The block onset, the duration of analgesia, and the time of discharge from the post-anesthesia care unit (PACU) were all assessed. Data were analyzed using SPSS software version 21, and P<0.05 were considered statistically significant.Results: The mean duration of motor blocks in the B group (150 min) were significantly higher than the BM (102 min) and BF (105 min) groups (P<0.0001). In both the BM and BF groups, the duration of sensory and motor blocks was the same. The length of stay in the PACU was significantly longer in the B group (P<0.001) than the BM and BF groups. When meperidine or fentanyl was added to bupivacaine, the duration of the analgesia lengthened (P<0.001). Conclusion: Intrathecal low-dose spinal anesthesia induced by bupivacaine (8 mg) in combination with meperidine and/or fentanyl for Cesarean section increased maternal hemodynamic stability, while ensuring effective anesthetic conditions, extending effective analgesia, and reducing the length of stay in PACU.Trial Registration Number: IRCT2015013119470N14.https://ijms.sums.ac.ir/article_48989_7bcfb2f91989a8e089eed8302a01cb74.pdfbupivacaineanesthesia, spinallocal anesthesiameperidinefentanylcesarean section |
| spellingShingle | Zeinabsadat Fattahi-Saravi Vida Naderi-Boldaji Azadeh Azizollahi Simin Azemati Naeimehossadat Asmarian Mohammad-Bagher Khosravi Adequate Anesthesia and More Effective Analgesia by Adjusted Doses of Bupivacaine during Cesarean Section: A Randomized Double-blind Clinical Trial Iranian Journal of Medical Sciences bupivacaine anesthesia, spinal local anesthesia meperidine fentanyl cesarean section |
| title | Adequate Anesthesia and More Effective Analgesia by Adjusted Doses of Bupivacaine during Cesarean Section: A Randomized Double-blind Clinical Trial |
| title_full | Adequate Anesthesia and More Effective Analgesia by Adjusted Doses of Bupivacaine during Cesarean Section: A Randomized Double-blind Clinical Trial |
| title_fullStr | Adequate Anesthesia and More Effective Analgesia by Adjusted Doses of Bupivacaine during Cesarean Section: A Randomized Double-blind Clinical Trial |
| title_full_unstemmed | Adequate Anesthesia and More Effective Analgesia by Adjusted Doses of Bupivacaine during Cesarean Section: A Randomized Double-blind Clinical Trial |
| title_short | Adequate Anesthesia and More Effective Analgesia by Adjusted Doses of Bupivacaine during Cesarean Section: A Randomized Double-blind Clinical Trial |
| title_sort | adequate anesthesia and more effective analgesia by adjusted doses of bupivacaine during cesarean section a randomized double blind clinical trial |
| topic | bupivacaine anesthesia, spinal local anesthesia meperidine fentanyl cesarean section |
| url | https://ijms.sums.ac.ir/article_48989_7bcfb2f91989a8e089eed8302a01cb74.pdf |
| work_keys_str_mv | AT zeinabsadatfattahisaravi adequateanesthesiaandmoreeffectiveanalgesiabyadjusteddosesofbupivacaineduringcesareansectionarandomizeddoubleblindclinicaltrial AT vidanaderiboldaji adequateanesthesiaandmoreeffectiveanalgesiabyadjusteddosesofbupivacaineduringcesareansectionarandomizeddoubleblindclinicaltrial AT azadehazizollahi adequateanesthesiaandmoreeffectiveanalgesiabyadjusteddosesofbupivacaineduringcesareansectionarandomizeddoubleblindclinicaltrial AT siminazemati adequateanesthesiaandmoreeffectiveanalgesiabyadjusteddosesofbupivacaineduringcesareansectionarandomizeddoubleblindclinicaltrial AT naeimehossadatasmarian adequateanesthesiaandmoreeffectiveanalgesiabyadjusteddosesofbupivacaineduringcesareansectionarandomizeddoubleblindclinicaltrial AT mohammadbagherkhosravi adequateanesthesiaandmoreeffectiveanalgesiabyadjusteddosesofbupivacaineduringcesareansectionarandomizeddoubleblindclinicaltrial |