A Comparative Study of Fractionated Versus Single Dose Injection for Spinal Anesthesia During Cesarean Section in Patients with Pregnancy-Induced Hypertension

Nugroho, Alfan Mahdi; Sugiarto, Adhrie; Chandra, Susilo; Lembahmanah, Laras; Septica, Rafidya Indah; Yuneva, Annisaa

doi:10.5812/aapm-85115

Cited by 11 publications

(9 citation statements)

References 8 publications

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“…In contrast to our study, Nugroho AM et al, 17 comparison of Fractionated and Single Dose Injection of Spinal anaesthesia for Cesarean Section patients with Pregnancy Induced Hypertension was done. They concluded that MAP was not significantly different the two groups.…”

Section: Discussioncontrasting

confidence: 60%

Bolus dose versus fractionated dose injection of hyperbaric bupivacaine in spinal anaesthesia among adult patients undergoing lower limb surgery: A prospective study

Srivastava¹,

Ahluwalia²,

Jheetay³

et al. 2020

IJCA

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Background and Aims: Spinal anaesthesia (SA) with bolus dose has rapid onset but rapid onset may precipitate hypotension. If local anaesthetic is injected in fractions with some time gap, it may provide dense block with haemodynamic stability and prolonged duration of analgesia. We aimed to compare bolus dose with fractionated dose in SA for haemodynamic stability and duration of analgesia in patients undergoing lower limb surgery. Materials and Methods: After the Institutional Ethics Committee clearance, the study was carried out in sixty patients undergoing lower limb surgery. Patients were divided into two groups. Group B patients received single bolus SA with injection bupivacaine heavy (0.5%), 3 ml and Group F patients fractionated dose with two-third (2ml) of the total dose of injection bupivacaine heavy (0.5%) given initially followed by one-third (1ml) dose after 90s. Time of onset and regression of sensory and motor blockage, intraoperative haemodynamics and duration of analgesia were recorded and analysed with Student's unpaired t-test. Result: Patients were more haemodynamically stable in Group F as compared to Group B. Five patients in Group F and ten patients in Group B required vasopressor. Duration of sensory and motor block and duration of analgesia were longer in Group F compared to Group B. Conclusion: Fractionated dose of SA provides greater haemodynamic stability and longer duration of analgesia compared to bolus dose.

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Section: Discussioncontrasting

confidence: 60%

Bolus dose versus fractionated dose injection of hyperbaric bupivacaine in spinal anaesthesia among adult patients undergoing lower limb surgery: A prospective study

Srivastava¹,

Ahluwalia²,

Jheetay³

et al. 2020

IJCA

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“…Moreover, a spinal block technique can take a shorter time than an epidural block (3). Some studies mentioned that spinal analgesia not only can be applied more easily but also is faster, less expensive, and more effective than epidural analgesia (4)(5)(6)(7)(8)(9)(10)(11). Administration of opioid drugs in neuraxial blocks, which do not affect the sympathetic activity, along with local anesthetics, is a common technique to avoid negative consequences such as hypotension in these techniques (12)(13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia

Rahmati

Shahriari

et al. 2021

Anesth Pain Med

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Objectives: This study aimed to compare the analgesic effect of single-dose spinal versus epidural analgesia for labor pain to verify if applying a single dose spinal analgesia is an efficient technique for labor pain management as an alternative for epidural analgesia. Methods: A total of 128 women in the active phase of labor were randomly allocated into two groups of spinal analgesia (n = 64) and epidural analgesia (n = 64). The latter received a bolus dose of 16 mL of 0.125% bupivacaine and 50 μg fentanyl and repeated 5 - 10 mL of bolus dose. The former received 2.5 mg hyperbaric bupivacaine plus 50μg fentanyl. Pain intensity was measured using the visual analog scale (VAS). The duration of analgesia, mode of delivery, the duration of labor, side effects, and maternal satisfaction were also compared. Results: There were no significant differences in the rate of cesarean section, duration of labor, postpartum hemorrhage, and the frequency of the fetal heart deceleration until 30 min after analgesia between the two groups. Measured pain after 30 (P = 0.0001) and 90 min (P = 0.01) was significantly lower in the spinal group than the epidural group. However, there was no significant difference between the spinal and epidural groups concerning the VAS scores at 150, 210, and 270 minutes. Maternal satisfaction was higher in the spinal group (P = 0.002). The mean duration of analgesia was longer in the spinal group than the epidural group (P = 0.0001). Conclusions: According to the findings, single-dose spinal analgesia, compared to epidural analgesia, is a safe, fast, and efficient technique for labor analgesia, which can be easily performed. In addition, it provides a high satisfaction level in the parturient.

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“…This problem is inherent to SA and is difficult to resolve. Alfan et al 17 showed that, in obstetric patients with PIH who underwent CS, MAP was not significantly different by changing the method of anesthetic administration to SA (either fractioned dose injection or single-dose injection).…”

Section: Discussionmentioning

confidence: 99%

Comparison of three neuraxial anesthesia approaches in parturient women with obesity and pregnancy-induced hypertension who underwent cesarean section

Li¹,

Chen²,

Ren³

2021

J Int Med Res

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Objective To compare the effectiveness of different approaches of neuraxial anesthesia in parturient women with obesity and pregnancy-induced hypertension (PIH) who undergo cesarean section (CS). Methods We retrospectively analyzed data from 108 parturient women with obesity and PIH who underwent CS. All women were divided into the following three groups according to the neuraxial anesthesia approach: spinal anesthesia (SA), epidural anesthesia (EA), and combined spinal–epidural anesthesia (CSE). Clinical variables were compared. Results The mean age of the patients was 27.3 ± 2.2 years. Women in the CSE group had a longer duration from puncture to surgery, smaller intraoperative change in mean arterial pressure, higher Apgar scores at 1 and 5 minutes, shorter surgery time, lower rates of nausea and vomiting, and lower rate of intraoperative hypotension compared with those in the SA and EA groups. Conclusion CSE takes longer to administer in parturient women with obesity and PIH who undergo CS compared with those who have SA or EA. However, CSE has several advantages over SA or EA, including a shorter surgery time, more stable intraoperative mean arterial pressure, lower rates of nausea, vomiting, and intraoperative hypotension, and better Apgar scores at 1 and 5 minutes.

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A Comparative Study of Fractionated Versus Single Dose Injection for Spinal Anesthesia During Cesarean Section in Patients with Pregnancy-Induced Hypertension

Cited by 11 publications

References 8 publications

Bolus dose versus fractionated dose injection of hyperbaric bupivacaine in spinal anaesthesia among adult patients undergoing lower limb surgery: A prospective study

Bolus dose versus fractionated dose injection of hyperbaric bupivacaine in spinal anaesthesia among adult patients undergoing lower limb surgery: A prospective study

Effectiveness of Spinal Analgesia for Labor Pain Compared with Epidural Analgesia

Comparison of three neuraxial anesthesia approaches in parturient women with obesity and pregnancy-induced hypertension who underwent cesarean section

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