Randomised controlled trial of spinal anaesthesia with bupivacaine or 2‐chloroprocaine during caesarean section

Maes, Sielte; Laubach, Monika; Poelaert, Jan

doi:10.1111/aas.12665

Cited by 21 publications

(18 citation statements)

References 31 publications

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“…1 In addition, to our knowledge, since no study on intrathecal HP has reported before the time to T4 dermatome, we believed that 15 min delay was consistent with the results concluded on bupivacaine for CS, varying between 4 and 12 min. 4,37,38 Overall, surgical anesthesia was effective in 35 of 40 patients (87.50%), for the prede ned assessed doses, which can be consider as a high success rate comparing with reported results on other local anesthetics. 10,39 Interestingly, our results provide evidence that a dose of HP between 45 and 50 mg is su cient to ensure surgical anesthesia to a T4 sensory level, which is in fact lower comparing to the doses reported by previous dose-nding studies.…”

Section: Discussionmentioning

confidence: 56%

“…The de nition of a successful block differs widely amongst dose-nding studies having investigated the potency of intrathecal local anesthetics for cesarean section. 1,10,[35][36][37] In this study, we de ned as "success" the combination of a bilateral T4 attained sensory level obtained within 15 min after intrathecal HP dose administration with no pain experienced upon incision and until the end of surgery. We did this choice for the following reasons.…”

Section: Discussionmentioning

confidence: 99%

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Determination of the ED95 of intrathecal hyperbaric prilocaine with sufentanil for scheduled cesarean delivery: A dose-finding study based on the continual reassessment method

Goffard

Vercruysse

Leloup

et al. 2020

Preprint

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Background – Scheduled cesarean section is routinely performed under spinal anesthesia using hyperbaric bupivacaine. The current study was undertaken to determine the clinically relevant 95% effective dose of intrathecal 2% hyperbaric prilocaine co-administered with sufentanil for scheduled cesarean section, using continual reassessment method.Methods – We conducted a dose-response, prospective, double-blinded study to determine the ED95 values of intrathecal hyperbaric prilocaine used with 2,5 mcg of sufentanil and 100 mcg of morphine for cesarean delivery. Each parturient enrolled in the study received an intrathecal dose of hyperbaric prilocaine determined by the CRM and the success or failure of the block was assessed as being the primary endpoint.Results – The doses given for each cohort varied from 35 to 50 mg of HP, according to the CRM, with a final ED95 lying between 45 and 50 mg of Prilocaine after completion of the 10 cohorts. Few side effects were reported and patients were globally satisfied.Conclusions – The ED95 of intrathecal hyperbaric prilocaine with sufentanil 2.5 μg and morphine 100 μg for elective cesarean delivery was found to be between 45 and 50 mg. It may be an interesting alternative to other long-lasting local anesthetics in this context.Trial registration – The study was registered on January 30, 2017 – retrospectively registered – and results posted at the public database clinicaltrials.gov (NCT03036384 – https://clinicaltrials.gov/ct2/show/NCT03036384).

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Determination of the ED95 of intrathecal hyperbaric prilocaine with sufentanil for scheduled cesarean delivery: A dose-finding study based on the continual reassessment method

Goffard

Vercruysse

Leloup

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The definition of a successful block differs widely amongst dose-finding studies having investigated the potency of intrathecal local anesthetics for cesarean section [1,10,[35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Determination of the ED95 of intrathecal hyperbaric prilocaine with sufentanil for scheduled cesarean delivery: a dose-finding study based on the continual reassessment method

et al. 2020

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Background Scheduled cesarean section is routinely performed under spinal anesthesia using hyperbaric bupivacaine. The current study was undertaken to determine the clinically relevant 95% effective dose of intrathecal 2% hyperbaric prilocaine co-administered with sufentanil for scheduled cesarean section, using continual reassessment method. Methods We conducted a dose-response, prospective, double-blinded study to determine the ED95 values of intrathecal hyperbaric prilocaine used with 2,5 mcg of sufentanil and 100 mcg of morphine for cesarean delivery. Each parturient enrolled in the study received an intrathecal dose of hyperbaric prilocaine determined by the CRM and the success or failure of the block was assessed as being the primary endpoint. Results The doses given for each cohort varied from 35 to 50 mg of HP, according to the CRM, with a final ED95 lying between 45 and 50 mg of Prilocaine after completion of the 10 cohorts. Few side effects were reported and patients were globally satisfied. Conclusions The ED95 of intrathecal hyperbaric prilocaine with sufentanil 2.5 μg and morphine 100 μg for elective cesarean delivery was found to be between 45 and 50 mg. It may be an interesting alternative to other long-lasting local anesthetics in this context. Trial registration The study was registered on January 30, 2017 – retrospectively registered – and results posted at the public database clinicaltrials.gov (NCT03036384).

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“…3 Neuraxial anaesthesia and general anaesthesia can be performed in caesarean section. 4 , 5 However, in clinical practice, some anaesthetics (e.g., opioids) have a potential for respiratory depression of neonates, 6 which leads to a decrease in Apgar scores and pH values. If the neonatal Apgar score is < 7 at 5 min or pH is < 7.20, newborns are admitted to the neonatal intensive care unit.…”

Section: Introductionmentioning

confidence: 99%

Foetal responses to dexmedetomidine in parturients undergoing caesarean section: a systematic review and meta-analysis

et al. 2017

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ObjectiveThis current meta-analysis was conducted to evaluate effects of dexmedetomidine on neonatal maternal factors.MethodsThe electronic databases of PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched. The primary outcomes were neonatal parameters, including umbilical blood gases and Apgar scores. The secondary outcomes were maternal parameters.ResultsWe identified six randomized controlled trials (RCTs). No differences in neonatal umbilical blood gases, and Apgar scores at 1 min (WMD: −0.09; 95% CI: −0.21 to 0.04; I2 = 0%) and 5 min (weighted mean difference (WMD): 0.03; 95% CI: −0.05 to 0.11; I2 = 37%) were observed with dexmedetomidine. For maternal parameters, characteristics of motor and sensory block and postoperative analgesia (standard mean difference (SMD): 3.99; 95% CI: 2.85 to 5.12; I2 = 78%) were significantly improved after dexmedetomidine treatment. Adverse events, including nausea/vomiting and shivering (risk ratio (RR): 0.26; 95% CI: 0.11 to 0.60; I2 = 0%), were lower after dexmedetomidine treatment.ConclusionThis meta-analysis shows that dexmedetomidine is safe for neonates who are delivered by caesarean section. Moreover, dexmedetomidine used in neuraxial anaesthesia can improve the characteristics of motor and sensory block and prolong the maternal pain-free period. Dexmedetomidine can also reduce the maternal incidence of postoperative adverse effects.

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Randomised controlled trial of spinal anaesthesia with bupivacaine or 2‐chloroprocaine during caesarean section

Abstract: 2-Chloroprocaine can be used for low risk Caesarean section in healthy parturients. There is no difference in time to motor block resolution compared to bupivacaine. Motor recovery seems more predictable for 2-chloroprocaine and may be beneficial for the breastfeeding initiation.

Cited by 21 publications

References 31 publications

Determination of the ED95 of intrathecal hyperbaric prilocaine with sufentanil for scheduled cesarean delivery: A dose-finding study based on the continual reassessment method

Determination of the ED95 of intrathecal hyperbaric prilocaine with sufentanil for scheduled cesarean delivery: A dose-finding study based on the continual reassessment method

Determination of the ED95 of intrathecal hyperbaric prilocaine with sufentanil for scheduled cesarean delivery: a dose-finding study based on the continual reassessment method

Foetal responses to dexmedetomidine in parturients undergoing caesarean section: a systematic review and meta-analysis

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