Atashkhoei Simin, Abedini Naghi, Pourfathi Hojjat, Znoz Ali Bahrami, Marandi Pouya Hatami
Department of Anesthesia, Al-Zahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Iran J Med Sci. 2017 Mar;42(2):136-143.
After spinal anesthesia, patients undergoing cesarean section are more likely to develop hemodynamic changes. The baricity of local anesthetic has an important role on spinal blockade effects. The aim of this study was to compare the isobar and hyperbaric bupivacaine 0.5% plus fentanyl on maternal hemodynamics after spinal anesthesia for C/S.
In this double-blind study, 84 healthy pregnant women undergoing C/S using bupivacaine 0.5% isobar (study group, n=42) or hyperbaric (control group, n=42) for spinal anesthesia were scheduled. The study was conducted from 21 April 2014 to 21 November 2014 at Al-Zahra Hospital, Tabriz, Iran. Parameters such as maternal hemodynamics, block characteristics, side effects, and neonatal Apgar scores were recorded. Data were analyzed using the SPSS software by performing chi-square test, Fisher's exact test, one-way ANOVA, Mann-Whitney U-test, and student's t test.
The incidence of hypotension in the isobar group was lower than the hyperbaric group, although it was not statistically significant (40.47% vs. 61.9%, P=0.08). The duration of hypotension was shorter in the study group (1.6±7.8 min vs. 7.4±12.5 min, P=0.004). The dose of ephedrine was lower in the study group (2.4±6.6 mg vs. 5.3±10.7 mg, P=0.006). The main maternal side effect is sustained hypotension that was seen in 0 patients of the isobar and 7 (16.66%) of hyperbaric groups (P=0.006). None of the neonates had Apgar score≤7 at 5 min of delivery (P=1.0). Sensory and motor block duration was shorter in the study group (P=0.01).
Isobaric bupivacaine is associated with more hemodynamic stability and shorter sensory and motor blockade in mothers under spinal anesthesia for C/S. IRCT201401287013N7.
剖宫产患者在脊麻后更易出现血流动力学变化。局麻药的比重对脊麻效果有重要作用。本研究旨在比较等比重和重比重0.5%布比卡因加芬太尼用于剖宫产脊麻后对产妇血流动力学的影响。
在这项双盲研究中，纳入84例计划行剖宫产的健康孕妇，其中42例使用等比重0.5%布比卡因进行脊麻作为研究组，42例使用重比重0.5%布比卡因进行脊麻作为对照组。研究于2014年4月21日至2014年11月21日在伊朗大不里士的阿尔扎赫拉医院进行。记录产妇血流动力学、阻滞特征、副作用及新生儿阿氏评分等参数。使用SPSS软件进行数据分析，采用卡方检验、Fisher精确检验、单因素方差分析、Mann-Whitney U检验和学生t检验。
等比重组低血压发生率低于重比重组，尽管差异无统计学意义（40.47%对61.9%，P = 0.08）。研究组低血压持续时间较短（1.6±7.8分钟对7.4±12.5分钟，P = 0.004）。研究组麻黄碱用量较低（2.4±6.6毫克对5.3±10.7毫克，P = 0.006）。产妇主要副作用为持续性低血压，等比重组0例，重比重组7例（16.66%）（P = 0.006）。分娩5分钟时，无一例新生儿阿氏评分≤7分（P = 1.0）。研究组感觉和运动阻滞持续时间较短（P = 0.01）。
等比重布比卡因用于剖宫产脊麻时，产妇血流动力学更稳定，感觉和运动阻滞时间更短。IRCT201401287013N7。
