Abstract

Obstetric anesthesia carries great responsibilities because there are two patients, the mother and the fetus. The purpose of the present study is to compare two doses of Levobupivacaine for spinal anesthesia at elective cesarean section, to determine the best dose that can give mother and fetal hemodynamic stability and a fast anesthesia recovery after the surgery. Method: We conducted a prospective randomized comparative study in 56 patients undergoing cesarean section with spinal dose of Levobupivacaine 6 mg (22 patients) and 10 mg (34 patients), both groups combined with 25 μg of fentanyl. The two doses of local anesthetic were compared with regard to sensory and motor blockade, the need for supplementation epidural, the severity of hypotension and other complications. Result: The 6 mg of levobupivacaine group presents no difference in the incidence of hypotension, bradycardia, nauseas or vomiting compared with the 10 mg of levobupivacaine group, but presents higher incidence of supplementary analgesia and lower mother satisfaction. Conclusions: The combination of 6 mg of levobupivacaine with 25 μg of fentanyl on spinal anesthesia can be an option for short time cesarean section, buy doesn’t present a superior profile in side effects over the 10 mg of levobupivacaine with 25 μg of fentanyl combination with worst maternal satisfaction.

Highlights

  • The rate of caesarean section performed in the occidental countries has been increased through the last years

  • After institutional ethical approval and informed consent of each patient was obtained, 56 ASA II patients scheduled for elective cesarean section were enrolled in this prospective, randomized simple blind study

  • The universe of this study was all the patients programmed to elective cesarean section in the maternity of the Santo Tomas Hospital during the period of the study: March 1 to May 31 of 2013

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Summary

Introduction

The rate of caesarean section performed in the occidental countries has been increased through the last years. (2014) Comparison of a Standard Dose with a Low Dose of Levobupivacaine in Spinal Anesthesia for Caesarean Section. Neuroaxial anesthesia is safe, and spinal anesthesia brings excellent confidence to the anesthesiologist and the surgeon with a great maternal satisfaction, it is not exempt of complications. Some of these complications are hypotension with and incidence reported of 20% to 100% [5]-[7], nauseas and vomiting [5], uterus-placental perfusion decrease with fetal acidosis [8] [9] and an incomplete anesthetic blockage that can occur in 25% of the cases [10]

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