The Effect of pH Adjustment of Bupivacaine on Onset and Duration of Epidural Anaesthesia for Caesarean Section

McMorland, G. H.; Douglas, M. Joanne; Axelson, James E.; Kim, J. H.K.; Bliar, I.; Ross, P. L. E.; Gambling, David R.; Swenerton, Jean E.

doi:10.1097/00132582-198904000-00031

Cited by 2 publications

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“…The investigators disagree about the efficacy of this preparation. Some authors reported faster onset and better quality of sensory and motor blocks [22][23][24] . Others have failed to show any clinical advantages of alkalinization over a plain solution [25][26][27][28][29] .…”

Section: Discussionmentioning

confidence: 99%

Acid-base state of cerebrospinal fluid during pregnancy and its effect on spread of spinal anaesthesia

Hirabayashi

Shimizu

Saitoh

et al. 1996

British Journal of Anaesthesia

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To assess the possible relationship between changes in acid-base state of cerebrospinal fluid (CSF) and enhanced spread of spinal anaesthesia during pregnancy, we have measured CSF pH, carbon dioxide tension (PCO2) and HCO3- values in 73 women undergoing spinal anaesthesia with hyperbaric amethocaine 8 mg. Patients were allocated to one of four groups according to gestational period: non-pregnant group (n = 13), first trimester group (8-13 weeks, n = 19), second trimester group (14-26 weeks, n = 11) and third trimester group (27-39 weeks, n = 30). The pH of the CSF was greater in the second and third trimester groups than in the non-pregnant group. CSF PCO2 decreased by 0.53-0.8 kPa throughout pregnancy. CSF HCO3- was decreased throughout pregnancy. Overall, no clinically significant correlation was found between maximum cephalad spread of analgesia and CSF pH, PCO2 or HCO3-. We conclude that pregnancy-induced changes in acid-base state of CSF have little effect on the spread of spinal anaesthesia, although there is a clinically different spread of spinal anaesthesia between non-pregnant and pregnant states.

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Section: Discussionmentioning

confidence: 99%

Acid-base state of cerebrospinal fluid during pregnancy and its effect on spread of spinal anaesthesia

Hirabayashi

Shimizu

Saitoh

et al. 1996

British Journal of Anaesthesia

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show abstract

“…A decrease in onset time from 6.0 to 3.2 rain was found in the patients receiving epidural for analgesia in labour.5 One of the studies 4 in which epidural block for Caesarean section was compared showed an improvement in onset time from 6.4 to 3.2 rain (loss of temperature sensation at L~ measured at 30 sec intervals). 4 The other study on Caesarean sections 9 only measured loss of sensation every five minutes, therefore, it is not surprising that the difference in onset times that the fast study showed was not replicated. The two studies 7,8 comparing plain and alkalinzed bupivacaine in epidural block for lower extremities surgery showed no difference in onset times.…”

Section: Dh Morison Ms C~ Frcpcmentioning

confidence: 98%

Alkalinization of local anaesthetics

Morison

1995

Can J Anaesth

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The Effect of pH Adjustment of Bupivacaine on Onset and Duration of Epidural Anaesthesia for Caesarean Section

Cited by 2 publications

References 0 publications

Acid-base state of cerebrospinal fluid during pregnancy and its effect on spread of spinal anaesthesia

Acid-base state of cerebrospinal fluid during pregnancy and its effect on spread of spinal anaesthesia

Alkalinization of local anaesthetics

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