Intrathecal plainvs hyperbaric bupivacaine for labour analgesia: efficacy and side effects

@article{Rofaeel2007IntrathecalPH,
  title={Intrathecal plainvs hyperbaric bupivacaine for labour analgesia: efficacy and side effects},
  author={Ayman Rofaeel and Suzanne Lilker and Shafagh Fallah and Eric Goldszmidt and Josē Carlos Almeida Carvalho},
  journal={Canadian Journal of Anesthesia},
  year={2007},
  volume={54},
  pages={15-20}
}
PurposeBaricity is an important determinant of block characteristics of the spinal component of a combined spinal epidural (CSE) for labour analgesia. This study compares the analgesic efficacy and side effects of intrathecally administered plain and hyperbaric bupivacaine (both with fentanyl) during active labour.MethodsSixty-two women in active labour (cervical dilatation >- 5 cm and pain score > 5) were randomized in a prospective, single-blinded fashion to receive 2.5 mg of either… Expand
Determination of the ED95 for intrathecal plain bupivacaine combined with fentanyl in active labor.
TLDR
The first dose-finding study specifically designed to estimate the ED95 of intrathecal bupivacaine combined with a fixed amount of fentanyl for analgesia in active labor found the combination of bupvacaine 1.75 mg with fentanyl 15 microg rapidly and reliably alleviated pain in the active phase of labor. Expand
A DOUBLE BLIND COMPARATIVE STUDY BETWEEN INTRATHECAL BUPIVACAINE AND INTRATHECAL FENTANYLAS THE INITIAL DOSE OF COMBINED SPINAL EPIDURAL TECHNIQUE FOR LABOUR ANALGESIA
TLDR
Main side effects encountered in this study were motor weakness of longer duration in group II than in group I, and both the drugs provided excellent quality of analgesia to the parturient in pain. Expand
The effect of spinal hyperbaric bupivacaine–fentanyl or hyperbaric bupivacaine on uterine tone and fetal heart rate in labouring women: a randomised controlled study
TLDR
It was found that raised baseline uterine tone was not more frequent when using bupivacaine–fentanyl rather than bupavacaine in the spinal component of combined spinal‐epidural, although absolute values of baseline tone were higher, and fetal heart rate changes more frequent, in the former group. Expand
Effects Of Isobaric Bupivacaine In Endoscopic Urological Surgeries Under Spinal Anaethesia
TLDR
Intrathecal isobaric bupivacaine with low dose fentanyl may be used as an alternative to traditional hyperbaric buonavacaine for endoscopic urologic surgeries with less side effects related to intrathecal opioid. Expand
Single intrathecal fentanyl for combined spinal epidural anesthesia confers no advantage over hemodynamic effects in elderly patients.
TLDR
Intrathecal hyperbaric bupivacaine 2.5 mg plus fentanyl 25 microg administration provides shorter motor block onset time, less local anesthetic usage and adequate hemodynamic stability in elderly patients. Expand
Comparison of intrathecal hyperbaric and isobaric levobupivacaine in urological surgery.
TLDR
The clinical efficacy of hyperbaric levobupivacaine was superior to the isobaric form in spinal anesthesia for transurethral resection and no difference with regard to time to two segment regression of sensory block could be detected. Expand
The role of combined spinal epidural analgesia for labour: is there still a question?
  • R. Preston
  • Medicine
  • Canadian journal of anaesthesia = Journal canadien d'anesthesie
  • 2007
TLDR
Given the incidence of fetal bradycardia observed in both groups of Rofaeel’s study, perhaps it is time to reassess whether CSE should continue to have a role in labour analgesia, and one might conclude that IT isobaric bupivacaine should no longer be used. Expand
The anaesthetic and recovery profile of two concentrations (0.25% and 0.50%), of intrathecal isobaric levobupivacaine for combined spinal-epidural (CSE) anaesthesia in patients undergoing modified Stark method caesarean delivery: a double blinded randomized trial.
TLDR
The intraoperative effectiveness, hemodynamic effects, anaesthetic recovery times and patients satisfaction after isobaric levobupivacaine (L) 0.25% versus L0.50% for spinal anaesthesia for caesarean delivery with the Stark technique with good maternal satisfaction was compared. Expand
A comparison of the effects of hyperbaric and isobaric bupivacaine spinal anesthesia on hemodynamics and heart rate variability.
TLDR
Hyperbaric bupivacaine caused a significantly greater decrease in LF/HF ratios and a significantly great increase in HF values, which were significantly higher at 20 min after spinal anesthesia than the baseline value. Expand
A comparative study of the anesthetic potencies and hemodynamic changes of 0.5% isobaric levobupivacaine and 0.5% hyperbaric racemic bupivacaine for spinal anesthesia in lower abdominal and lower limb surgeries
Background: Spinal anesthesia is a preferable technique for lower abdominal surgeries as it provides effective sensory and motor block with rapid onset, attenuation of stress response and lessExpand
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Under these circumstances, hyperbaric bupvacaine conferred an increased duration of IT analgesia compared with plain bupivacaine. Expand
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A series of six cases exhibiting a high sensory block after intrathecal sufentanil for labor analgesia are reported, all of which were healthy parturients in active labor with a term, singleton, vertex fetus. Expand
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The present data corroborate previous recommendations of caution when performing CSE using a large dose (7.5 &mgr;g or more) of spinal sufentanil because of the risk of uterine hyperactivity and FHR abnormalities. Expand
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TLDR
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TLDR
The authors conclude that the addition of dextrose to intrathecal sufentanil injected into patients in the sitting position reduces the duration of analgesia without significantly reducing side effects with the exception of pruritus, and therefore does not improve the clinical utility of intratanil. Expand
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TLDR
This study evaluated intrathecal (IT) sufentanil for labor analgesia with respect to sensory changes, side effects, and fetal heart rate (FHR) changes to find out whether these changes were associated with adverse neonatal outcome or not. Expand
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TLDR
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TLDR
Intrathecal sufentanil in a dose of 7.5 μg has the potential to result in more nonreassuring fetal heart rate tracings compared with both intrathecal analgesia using a bupivacaine (2.5 mg)/sufentAnil (1.5mg) mixture and epidural analgesiaUsing bupvacaine, sufenil, and epinephrine. Expand
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TLDR
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A Randomized Study of Combined Spinal‐Epidural Analgesia versus Intravenous Meperidine during Labor: Impact on Cesarean Delivery Rate
TLDR
Combined spinal‐epidural analgesia during labor does not increase the cesarean delivery rate for dystocia in healthy parturient patients at full term, regardless of parity, however, an unexpected increase in the number of cESarean deliveries for profound fetal bradycardia after intrathecal sufentanil was observed. Expand
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