Abstract
In our study, we evaluated the effects of fentanyl added to intrathecal levobupivacaine or bupivacaine on the level of motor-sensory block, analgesia duration, patient satisfaction and newborn’s well being in patients undergoing elective cesarean section. The study was designed as a prospective, randomized and double-blind study. The patients were randomly allocated into two groups, so that patients in Group C received intrathecal isobaric 7.5 mg 0.5% levobupivacaine (1.5 ml) and 20 μg fentanyl (0.4 mL), while the ones in Group B had intrathecal isobaric 7.5 mg 0.5% bupivacaine (1.5 mL)and 20 μg fentanyl (0.4 mL). Following spinal anesthesia, hemodynamic parameters, onset and recovery time of sensorial and motor block, side effects, Apgar scores of the newborns, blood gas levels of the umblical artery, pain scores (VAS) of the patients, surgeon, patient and anesthesiologist satisfaction were recorded. The onset time for sensorial block and the requirement of ephedrine were similar in both groups. The recovery time of block to T10 and the initial analgesic requirement time were detected to be significantly longer in Group C. Duration of motor block was significantly longer in Group B (p=0,017). The intratechal fentanyl added to levobupivacaine or bupivacaine had similar effects both on the mother and the newborn.
Highlights
Intrathecal anesthesia in caesarean sections has become an established technique, and various local anesthetics and opioids have been used, either alone or in combination
There were no differences in maternal blood pressure and heart rate values between the two groups
There was no difference in pain scores (VAS), or in the incidence of inadequate anesthesia between the two groups
Summary
Intrathecal anesthesia in caesarean sections has become an established technique, and various local anesthetics and opioids have been used, either alone or in combination. Smaller doses of local anesthetics supplemented by intrathecal opioids have been recommended for spinal anesthesia in parturients undergoing cesarean section delivery [1,2]. Levobupivacaine is relatively recently introduced amino amide local anesthetic that is structurally similar to bupivacaine. Clinical studies all indicate that levobupivacaine is well tolerated and has an efficacy equivalant to bupivacaine for anesthesia and analgesia [3]. Levobupivacaine has been associated with less central nervous system and cardiac toxicity relative to bupivacaine when equal concentrations were compared [4,5]. Bupivacaine, an amide type of local anesthetic, has high potency and long duration of action (1.5-2 h). Its most serious side effect is cardiotoxicity and pregnant women are more susceptible to this side effect [4]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
