Rachianesthésie pour césarienne : la vitesse d'injection a-t-elle une influence sur l'incidence de l'hypotension ?

Abstract

Objective. – To study effect of injection rate on spinal blockade and haemodynamic of spinal bupivacaine for Caesarean section. Study design. – Prospective and randomized. Patients and methods. – Sixty ASA I-II patients scheduled for elective Caesarean section were randomized to receive either fast (20 seconds, group R, n = 30) or slow (60 seconds, group L, n = 30) spinal injection of 10 mg of hyperbaric bupivacaine 0.5% associated with 25 μg of fentanyl and 100 μg of morphine. Sensory and motor blockade and haemodynamic parameters were recorded. Results. – Profiles of sensory and motor block were similar in both groups. Variations of arterial blood pressure and total dose of ephedrine were not different between R and L groups. However, the number of patient with systolic blood pressure lower than 100 mmHg were significantly lower in L group than in R group ( p = 0.04). Incidences of adverse effects were similar in both groups. Conclusion. – Result of the present study suggests that a slow rate of injection would induce lower incidence of hypotension induced by spinal bupivacaine for Caesarean section.