Levobupivacain zur Spinalanästhesie bei der Sectio caesarea

Bremerich, Dorothee H.; Kuschel, Stefanie; Fetsch, Nathalie; Zwißler, Bernhard; Byhahn, Christian; Meininger, Dirk

doi:10.1007/s00101-007-1201-1

Cited by 9 publications

(5 citation statements)

References 32 publications

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“…Bremerich et al found that, compared with 7.5 mg of levobupivacaine, 10 and 12.5 mg of levobupivacaine prolonged the duration of effective analgesia postoperatively (45 vs. 81 and 96 min, respectively). [11] These authors recommended 10 mg of levobupivacaine for patients undergoing elective cesarean delivery with spinal anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effect of adding midazolam versus fentanyl to intrathecal levobupivacaine in patients undergoing cesarean section: double-blind, randomized clinical trial

AbdelRady

Fathy

Abdallah

et al. 2024

Brazilian Journal of Anesthesiology (English Edition)

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Section: Discussionmentioning

confidence: 99%

Comparison of the effect of adding midazolam versus fentanyl to intrathecal levobupivacaine in patients undergoing cesarean section: double-blind, randomized clinical trial

AbdelRady

Fathy

Abdallah

et al. 2024

Brazilian Journal of Anesthesiology (English Edition)

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“…found that, compared to 7.5 mg levobupivacaine, 10 and 12.5 mg levobupivacaine prolonged the duration of effective analgesia postoperatively (45 vs. 81 and 96 min, respectively). [6] These authors recommended 10 mg levobupivacaine for parturients undergoing elective cesarean section with spinal anesthesia. In our study, the dose used was similar.…”

Section: Discussionmentioning

confidence: 99%

“…The dose of local anesthetics administered (10 mg) was chosen in accordance with a recent dose-finding study. [6] Neither the anesthesiologist nor the parturient herself was aware of the drugs or dose administered. Randomization of the parturients was performed with sealed envelope technique, in which each treatment allocation was sealed in an individual envelope, and all sixty envelopes were shuffled.…”

Section: Methodsmentioning

confidence: 99%

“…Levobupivacaine, the S(-)-enantiomer of bupivacaine, recently introduced for obstetric spinal and epidural anesthesia[45] has been shown to provide a more selective neuraxial blockade than racemic bupivacaine. [6] Often, intrathecal opioids, such as fentanyl or sufentanil, are combined with local anesthetics, thereby markedly enhancing the quality and duration of postoperative analgesia after cesarean delivery as well as providing better parturient comfort without affecting neonatal outcome significantly. [7]…”

Section: Introductionmentioning

confidence: 99%

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Comparison of intrathecal levobupivacaine and levobupivacaine plus fentanyl for cesarean section

2017

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Aims and Objectives:The aim of this study is to compare the effects of intrathecal levobupivacaine with levobupivacaine and fentanyl in patients undergoing cesarean section.Methods:Patients with American Society of Anesthesiologists Physical Status I and II scheduled for cesarean section under spinal anesthesia were randomly allocated with thirty patients each. Group L: levobupivacaine group – thirty patients (10 mg). Group F: levobupivacaine plus fentanyl group – thirty patients (7.5 mg + 12.5 μg). Hemodynamic monitoring, sensory and motor levels, and neonatal Apgar score were noted intraoperatively. The total duration of motor and sensory block, time for rescue analgesia was noted postoperatively.Results:Prolonged duration of postoperative sensory and rescue analgesia was found in Group F – 112.97 ± 19.42, 231.26 ± 10.92 min as compared to Group L – 100.37 ± 10.64, 185.93 ± 11.09 min and duration of motor blockade was prolonged in Group L – 87.83 ± 15.04 min than Group F – 79.20 ± 8.93 min and P < 0.05 was found statistically significant. Apgar scores in both groups were comparable.Conclusion:Intrathecal levobupivacaine plus fentanyl prolonged duration of sensory block and rescue analgesia without prolonging motor block which could help in early ambulation.

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“…Recently Morris et al studied the impedance cardiography values either during normal pregnancy and postpartum after vaginal or cesarean delivery [ 3 ], while Tihtonen used ICG during the course of caesarian section in pre-eclamptic parturients [ 2 ]. However, to our knowledge, no data are available on impedance measurement during spinal anesthesia with different local anesthetic doses whereas several studies were focused on the optimal dose of local anesthetics to obtain a good anesthesia and reduce the motor block [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Impedance cardiography as tool for continuous hemodynamic monitoring during cesarean section: randomized, prospective double blind study

et al. 2018

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BackgroundImpedance Cardiography (ICG) is a non-invasive tool for continuous hemodynamic monitoring. Aims of our study were to assess the utility of ICG to evaluate the hemodynamic impact of 6 mg (GL6) vs 8 mg (GL8) levobupivacaine combined with fentanyl in healthy patients undergoing elective cesarean section; secondary, to compare the duration and quality of analgesia and anesthesia.MethodsSixty-two women receiving combined spinal-epidural (CSE) for elective cesarean delivery were randomly allocated to GL6 or GL8 groups. Mean arterial pressure (MAP), cardiac index (CI), systemic vascular resistance index (SVRI), heart rate (HR), stroke volume index (SVI) were recorded from Tbaseline to 31 min after CSE by ICG. Sensory and motor blocks, patients and surgeons satisfaction, neonatal data were also recorded.ResultsFifteen of 32 patients in GL6 and 15 of 30 patients in GL8 experienced hypotension at T2 vs Tbaseline (P < .001) and SVRI reduction (P = .035 and P < .001 respectively). MAP, CI and SVRI were always slightly higher in GL6 vs GL8. HR and SVI remained stable until the end of surgery in all patients. Total ephedrine requirements was higher in GL8 (P = .010). The onset and offset time of sensory and motor block were similar in both groups, but the number of patients with motor block was lower in GL6 vs GL8 (P = .001). Patients and surgeon satisfaction scores, the number of patients needed systemic rescue doses, neonatal data were similar in both groups.ConclusionsICG is a useful noninvasive tool to monitor continuously hemodynamics during cesarean section. The hemodynamic stability, the satisfying sensory block and rapid mobilization provided by low levobupivacaine dose may be particularly advantageous in obstetric patients.Trial registrationClinicalTrials.gov: NCT03170427. Retrospectively Registered (Date of registration: May 2017).

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Levobupivacain zur Spinalanästhesie bei der Sectio caesarea

Cited by 9 publications

References 32 publications

Comparison of the effect of adding midazolam versus fentanyl to intrathecal levobupivacaine in patients undergoing cesarean section: double-blind, randomized clinical trial

Comparison of the effect of adding midazolam versus fentanyl to intrathecal levobupivacaine in patients undergoing cesarean section: double-blind, randomized clinical trial

Comparison of intrathecal levobupivacaine and levobupivacaine plus fentanyl for cesarean section

Impedance cardiography as tool for continuous hemodynamic monitoring during cesarean section: randomized, prospective double blind study

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