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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Small dose spinal bupivacaine for Cesarean delivery does not reduce hypotension but accelerates motor recovery.
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Small dose spinal bupivacaine for Cesarean delivery does not reduce hypotension but accelerates motor recovery.

机译：用于剖宫产的小剂量脊髓布比卡因不会降低低血压，但会加速运动恢复。

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BACKGROUND: Maternal hypotension occurs in 60-94% of Cesarean deliveries with 10-15 mg spinal bupivacaine. Reduced doses of bupivacaine may decrease the incidence of hypotension, nausea, and vasopressor use. The primary objective of this study was to compare 4.5 mg and 12 mg doses of intrathecal bupivacaine on maternal hemodynamics. The secondary objective was to determine if anticipated reductions in side effects were reflected in increased patient satisfaction. METHODS: Following Research Ethics Board approval and informed consent 52 term parturients undergoing elective Cesarean delivery were randomly assigned to isobaric bupivacaine 4.5 mg or hyperbaric bupivacaine 12 mg for spinal anesthesia. All patients received fentanyl 50 microg and morphine 200 microg intrathecally. Intravenous fluid and vasopressor administration were standardized. Maternal hemodynamics, and sensorimotor levels were recorded at regular intervals. Side effects and patient satisfaction were documented. RESULTS: Median cepahaladsensory block was C8 in both groups (NS) but the intensity of motor block was significantly less (P < 0.001) and of shorter duration (P < 0.001) with bupivacaine 4.5 mg. The proportion of patients requiring ephedrine (> 70%) and the quantities of ephedrine used were similar in both groups (NS). Use of supplemental analgesia, side effects, and measures of patient satisfaction were comparable in both groups. DISCUSSION: Intrathecal bupivacaine 4.5 and 12 mg yielded similar sensory block and side effects during Cesarean delivery. Patients receiving 4.5 mg did, however, experience significantly less motor blockade of shorter duration.
机译：背景：产妇低血压发生在剖腹产的60-94％中，伴有10-15 mg的布比卡因脊髓。减少剂量的布比卡因可能会降低低血压，恶心和使用升压药的发生率。这项研究的主要目的是比较鞘内注射布比卡因4.5 mg和12 mg对孕妇血液动力学的影响。次要目标是确定副作用的预期减少是否反映在患者满意度的提高中。方法：经伦理学委员会批准并知情同意后，将52名接受择期剖宫产的足月产妇随机分配至等压布比卡因4.5 mg或高压布比卡因12 mg用于脊髓麻醉。所有患者鞘内注射芬太尼50微克和吗啡200微克。静脉输液和升压药的给药是标准化的。定期记录产妇的血流动力学和感觉运动水平。记录了副作用和患者满意度。结果：两组（NS）的中隔头晕感觉阻滞均为C8，但布比卡因4.5 mg的运动阻滞强度明显降低（P <0.001），持续时间较短（P <0.001）。两组中需要麻黄碱的患者比例（> 70％）和麻黄碱的使用量相似。两组中使用辅助镇痛，副作用和患者满意度的方法均相当。讨论：剖宫产术中鞘内注射布比卡因4.5和12 mg产生相似的感觉阻滞和副作用。但是，接受4.5 mg的患者的病程较短，但运动障碍明显减少。

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