Subarachnoid Block With Hyperbaric Bupivacaine and Morphine May Shorten PACU Stay After Cesarean Delivery

Lehavi, Amit; Abecasis, Philippe; Weissman, Amir; Winterstern, Aaron; Katz, Yeshaayahu S.

doi:10.1016/j.jopan.2010.07.011

Cited by 5 publications

(3 citation statements)

References 32 publications

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“…Several adjuncts have been added to intrathecal bupivacaine to prolong the duration of sensory block. Such adjuncts include the use of fentanyl [6], sufentanil [7], morpine [8], clonidine [9], and dexmedetomidine [10] just to mention but a few.…”

Section: Introductionmentioning

confidence: 99%

Comparative Effects of Single Shot Intrathecal Bupivacaine with Dexmedetomidine and Bupivacaine with Fentanyl on Labor Outcome

Fyneface-Ogan

Job

Enyindah

2012

ISRN Anesthesiology

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Background. Effective intrapartum analgesia attenuates pain, stress, and anxiety which cause release of stress hormones as well as beta-endorphins.Aim. The purpose of this study was to determine the effect of adding dexmedetomidine to hyperbaric bupivacaine for neuraxial analgesia for labor.Methods. Ninety laboring multiparous women were allocated to have single shot intrathecal bupivacaine alone (B), bupivacaine with fentanyl (BF), or bupivacaine with dexmedetomidine (BD). Sensory and motor block characteristics; time from injection to two dermatome sensory regression, sensory regression to S1 dermatome, and motor block regression to Bromage 1 were recorded. Labor pain was assessed with a 10 cm verbal pain scale.Results. Peak sensory block levels in the three groups were essentially the same (). The time for sensory and motor blocks to reach T10 dermatome and Bromage 1, respectively, was faster in group BD than in the other groups (). The time for sensory regression to S1 was significantly prolonged in the group BD (). Motor block regression time to Bromage 1 was also prolonged in the group BD (). Neonatal outcome was normal in all groups.Conclusion. Single shot intrathecal bupivacaine/dexmedetomidine significantly prolonged sensory block in laboring women.

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Section: Introductionmentioning

confidence: 99%

Comparative Effects of Single Shot Intrathecal Bupivacaine with Dexmedetomidine and Bupivacaine with Fentanyl on Labor Outcome

Fyneface-Ogan

Job

Enyindah

2012

ISRN Anesthesiology

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“…Administration of a single intrathecal low dose of bupivacaine for labor analgesia has been demonstrated and found to be effective [ 4 ]. Various adjuvants such as fentanyl [ 4 ], sufentanil [ 5 ], morphine [ 6 ], clonidine [ 7 ], and dexmedetomidine [ 8 ] have been added to intrathecal bupivacaine in local anesthesia to provide a prolonged duration of sensory block and reduce the dose of intrathecal local anesthetic, which can subsequently decrease the incidence of spinal-induced hypotension. Dexmedetomidine (DMT), centrally acting 2-selective agonist ( α 2-AR), has been reported to prolong the duration of spinal analgesia when adding to local anesthetic so it reduces the dose of intrathecal local anesthetics and the requirements for opioids in postoperative pain control [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Analgesic Characteristics of Bupivacaine Alone and in Combination with Dexmedetomidine or Meperidine in Spinal Anesthesia during Cesarean Section: A Double-Blind Randomized Clinical Trial Study

Azemati

Zarghami²,

Jouybar

et al. 2022

Pain Research and Management

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Background. Comparing bupivacaine’s adjuvants in spinal anesthesia, we assessed the specific blocking characteristics and adverse effects of bupivacaine alone and in combination with dexmedetomidine or meperidine in spinal anesthesia during cesarean section. Methods. In this double-blind randomized clinical trial study, ninety pregnant women were divided into groups to receive 10 mg bupivacaine (group B), 10 mg bupivacaine with 5 μg dexmedetomidine (group BD), or 10 mg bupivacaine with 10 mg meperidine (group BM) intrathecal. Patients were assessed for the quality of analgesia during operations. Durations of sensory and motor blocks and anesthesia-related complications were analyzed using SPSS 21, and p values <0.05 were considered statistically significant. Results. The onset of sensory and motor blocks was essentially the same in all treated groups. Block regression time was significantly prolonged in the BD group compared to the B and BM groups ( p < 0.001 ). The duration of analgesia was significantly longer in the BD and BM groups than in the B group ( p < 0.001 ). The level of sedation in the BD group was higher than in the B group. Shivering occurred in 40% of patients in the B group, which was significantly more than that of the BD (16.6%) and BM (33.3%) groups. Itching happened in 33.3% of women in the BM group which was statistically more than that of the B (3.33%) and BD (0) groups. The incidence of adverse effects was the same in all groups. Conclusion. The combination of bupivacaine with dexmedetomidine significantly prolonged sensory and motor regression time and duration of analgesia.

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“…BUPI was inappropriate for use in the caprine species. However, low-dose BUPI has been used to provide pain control for the entirety of surgical procedures in humans [9][10][11][12][13][14] and bovine calves 15,16 without observing prolonged motor blockade.…”

mentioning

confidence: 99%

Comparison of subarachnoid administration of low-dose bupivacaine and lidocaine in healthy goats

Fackler,

Pablo,

Chiavaccini

et al. 2024

ajvr

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OBJECTIVE This study aimed to compare the effects of low-dose subarachnoid injections of 2% lidocaine (LIDO) and 0.5% bupivacaine (BUPI) in goats. ANIMALS 6 healthy, privately owned female goats. METHODS In this randomized blind crossover clinical trial, each goat received 0.05 mL/kg−1 of LIDO, BUPI, or sterile saline solution into the lumbosacral subarachnoid space, with a seven-day washout. Cardiorespiratory variables, rectal temperature, and somatosensory (pinprick) and motor (ataxia) functions were recorded at baseline (time 0) and 2, 5, 10, 15, and 30 minutes after injection, then every 20 minutes until the goat was standing and able to walk. Time to regain somatosensory and motor functions was compared between treatments using Kaplan-Meier survival curves and the Cox proportional hazards model. Linear mixed-effects models were used to compare cardiorespiratory variables between treatments and over time. A P value ≤ .05 was considered significant. RESULTS Somatosensory recovery was longer with BUPI, though not statistically significant. The median time to stand was 50 (50, 67) minutes after LIDO injection and 104 (101, 156) minutes after BUPI injection (P = .031). The median time to walk was 72 (54, 85) minutes after LIDO versus 225 (220, 245) minutes after BUPI injection (P = .031). Cardiovascular and respiratory variables showed no significant differences between treatments. CLINICAL RELEVANCE Despite prolonged ataxia with BUPI, pinprick sensation recovery did not differ. At reduced doses, both LIDO and BUPI are deemed acceptable for short procedures of the flank, pelvic limb, or tail in healthy goats.

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Subarachnoid Block With Hyperbaric Bupivacaine and Morphine May Shorten PACU Stay After Cesarean Delivery

Cited by 5 publications

References 32 publications

Comparative Effects of Single Shot Intrathecal Bupivacaine with Dexmedetomidine and Bupivacaine with Fentanyl on Labor Outcome

Comparative Effects of Single Shot Intrathecal Bupivacaine with Dexmedetomidine and Bupivacaine with Fentanyl on Labor Outcome

Analgesic Characteristics of Bupivacaine Alone and in Combination with Dexmedetomidine or Meperidine in Spinal Anesthesia during Cesarean Section: A Double-Blind Randomized Clinical Trial Study

Comparison of subarachnoid administration of low-dose bupivacaine and lidocaine in healthy goats

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