A randomized double-blind comparison of low-dose and high-dose bupivacaine for caesarean section in severely preeclamptic women using invasive blood pressure monitoring

Jain, Kajal; Makkar, Jeetinder Kaur; Anbarasan, Iswarya; Yadanappudi, S.; Gander, Shalini

doi:10.4103/2249-4472.123302

Cited by 6 publications

(6 citation statements)

References 24 publications

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“…The trend of MAP was comparable in the 3 groups even after anesthetic dose (P>0.05). In similar study by Jain et al [26] , mean baseline MAP was comparable in low-dose and high-dose groups. Thus, lower doses of bupivacaine can result in less reduction of MAP.…”

Section: Mean Arterial Pressuresupporting

confidence: 51%

“…This was in concordance with the study by Mebazaa et al [20] , there was no significant difference in the neonatal APGAR scores at 1 minute and 5 minutes between Group A (10mg) and Group B (7.5mg). In another study by Kiran et al [21] , Cenkowski et al [22] , Venkata et al [25] , and Jain et al [26] , there were no differences between groups in 1-or 5-min Apgar scores.…”

Section: Effects On Apgar Scorementioning

confidence: 92%

“…(Table 4) Other comparative studies also had no significant difference in the demographic variables among the groups. [21][22][23][24][25][26][27] Cenkowski et al [22] , reported that the average age in the conventional dose group was 31±3 versus 32 ± 6 years in the low dose group, Venkata et al [25] , study group had comparable mean age of the patients (24±2.1 vs 23±1.5); comparable weight (68±5.0 vs 64±4.84); comparable height (156±6.5 vs 158±9.0); and comparable ASA status (I/II vs I/II) (P>0.05), Mebazaa et al [20] as compared to conventional dose group (Group A), low-dose Group (Group B) had similar age (33 ± 6 vs 32 ± 5); similar weight (78 ± 10 vs 77 ± 9); similar height (…”

Section: Demographic Datamentioning

confidence: 99%

“…Thus, lower doses of bupivacaine can result in less reduction of MAP. In high-risk pregnancies, the reduced changes in MAP and less vasopressor use can specifically be useful (e.g., coexisting cardiac disease, early onset preeclampsia) [26] ,…”

Section: Mean Arterial Pressurementioning

confidence: 99%

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A randomized prospective study comparing conventional dose to low dose of hyperbaric bupivacaine for spinal anaesthesia in elective caesarean section

Singh¹,

Varshney²,

Jheetay³

et al. 2020

Int. J. Med. Anesthesiology

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Background: For caesarean sections, local anesthetics e.g. bupivacaine, chloroprocaine, levobupivacaine, lidocaine, ropivacaine, and tetracaine have been used generally in combination usually with opioids like morphine or fentanyl or its derivatives. Aim and Objectives: Thus this study was conducted to compare the efficacy of two different doses of 0.5% hyperbaric bupivacaine (7.5mg and 10mg) in women undergoing caesarean section. Materials and Method:The study was conducted in the Department of Anaesthesiology, Teerthanker Mahaveer hospital, TMU, Moradabad among 80 American Society of Anaesthesiologists (ASA) physical status I and II patients scheduled for elective caesarean section. The spinal anaesthetic haemodynamic parameters, i.e., Heart Rate, Non Invasive Blood Pressure, ECG, MAP and SpO2 were monitored. The sensory and motor onset time and time to regression were recorded. Results: Group B patients had significantly higher pulse rate post-spinal(P<0.05); significantly lower pulse rate at 6,8,10,16,19,25,30,35,40,45 and 60 minutes. Group B patients had significantly high systolic blood pressure post-spinal, at 2, 4, 6, 35, and 50 minutes. Group B patients took significantly more time to attain maximum motor and sensory block than group A. APGAR scores of the neonates born to the patients of the two groups were compared. Group B patients had significantly high mean diastolic and MAP post-spinal, 2, 4, and at 6 minutes. Conclusion: Low dose (7.mg) Bupivacaine shows better hemodynamic stability whereas the conventional dose (10mg) showed a faster onset/duration of sensory block and a prolonged motor block.

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Section: Mean Arterial Pressuresupporting

confidence: 51%

Section: Effects On Apgar Scorementioning

confidence: 92%

Section: Demographic Datamentioning

confidence: 99%

Section: Mean Arterial Pressurementioning

confidence: 99%

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A randomized prospective study comparing conventional dose to low dose of hyperbaric bupivacaine for spinal anaesthesia in elective caesarean section

Singh¹,

Varshney²,

Jheetay³

et al. 2020

Int. J. Med. Anesthesiology

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“…As the average weight and height of our subjects resemble ones from other populations in Southeast Asia (18), this study can be applicable to similar populations of parturients. Previous studies in Asian setting were conducted in India (19, 20), Korea (21), and Japan (22). From Southeast Asia, there is a study in a Singaporean setting, but they used Combined Spinal-Epidural, that technically is not always feasible in a lot of obstetric care settings in Southeast Asia (13).…”

Section: Discussionmentioning

confidence: 99%

How Low Can We Go? A Double-Blinded Randomized Controlled Trial to Compare Bupivacaine 5 mg and Bupivacaine 7.5 mg for Spinal Anesthesia in Cesarean Delivery in Indonesian Population

et al. 2019

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Background Maternal hypotension in cesarean delivery related to spinal anesthesia results in increasing morbidity of both mothers and children. Studies show that low dose spinal anesthesia was able to prevent hypotension while providing adequate analgesia. However, the dose used in those studies varies and this leaves the debate of the dose scheme of spinal anesthesia open. Objectives This study aimed to compare the effectiveness of 5 mg hyperbaric bupivacaine 0.5% and 25 mcg of fentanyl with 7.5 mg hyperbaric bupivacaine 0.5% and 25 mcg of fentanyl to prevent hypotension in spinal anesthesia for cesarean delivery. Methods This study was a double-blinded randomized controlled trial of 112 mothers undergoing cesarean delivery with spinal anesthesia. The intervention group received 5 mg bupivacaine and 25 mcg fentanyl. The comparison group received of 7.5 mg bupivacaine and 25 mcg fentanyl. The primary outcome was the incidence of hypotension. The adequacy of anesthesia, duration of recovery from the motoric block, the quality of analgesia as perceived by patients and surgeons, and the side effects of anesthesia were also recorded. Results There was no difference of effectiveness to prevent hypotension in both groups. The 7.5 mg dose provided better adequacy of anesthesia as reflected in lower incidence of conversion into general anesthesia. More surgeons reported adequacy of relaxation in the 7.5 mg dose. The 5 mg dose offered faster motoric recovery and fewer side effects. Conclusions The dose of 7.5 mg hyperbaric bupivacaine 0.5% and 25 mcg of fentanyl can be used as a prevention measure against hypotension due to spinal anesthesia cesarean delivery.

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Comparison of hemodynamic changes and fetal outcome between normotensive and preeclamptic parturient undergoing elective cesarean section under spinal anesthesia: A prospective observational cohort study

Mulugeta

Bantie²

2022

Annals of Medicine &Amp; Surgery

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A randomized double-blind comparison of low-dose and high-dose bupivacaine for caesarean section in severely preeclamptic women using invasive blood pressure monitoring

Cited by 6 publications

References 24 publications

A randomized prospective study comparing conventional dose to low dose of hyperbaric bupivacaine for spinal anaesthesia in elective caesarean section

A randomized prospective study comparing conventional dose to low dose of hyperbaric bupivacaine for spinal anaesthesia in elective caesarean section

How Low Can We Go? A Double-Blinded Randomized Controlled Trial to Compare Bupivacaine 5 mg and Bupivacaine 7.5 mg for Spinal Anesthesia in Cesarean Delivery in Indonesian Population

Comparison of hemodynamic changes and fetal outcome between normotensive and preeclamptic parturient undergoing elective cesarean section under spinal anesthesia: A prospective observational cohort study

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