Use Of Hyperbaric Bupivacaine Research Articles

Study to compare the effect of Dexmedetomidine vs MgSo4 (50%) intrathecally as an adjuvant with bupivacaine (0.5%) for lower limb orthopedic surgery under subarachnoid block

Lower limb surgeries may be performed under local, regional (spinal or epidural) or general anesthesia, but neuraxial blockade is the preferred mode of anesthesia. Sub-arachnoid block or Spinal anaesthesia is the most common central block used in a surgical setting, which is being the most versatile and commonly used regional block. With increasing use of hyperbaric bupivacaine for sub arachnoid block, their limitations like prolongation of onset of sensory and motor blockage effect, short duration of action and early postoperative requirement of an analgesic agent, require an intrathecal adjuvant to these local anaesthetic agents for a complete satisfactory period of anaesthesia and patient satisfaction. The aim of this study was to compare and evaluate the effect of Dexmedetomidine with MgSO4 (50%) intrathecally as an adjuvant for the characteristics of sensory and motor blockage for lower limb orthopedic surgery under subarachnoid block along with bupivacaine (0.5%). : Participants were randomly divided into two groups of 40 participants each. Group D (n=40) received Bupivacaine + dexmedetomidine, Group M (n=40) received Bupivacaine + MgSO4. Under strict aseptic and antiseptic precaution subarachnoid block was performed. Mixture of drugs according to group assign was injected. Assessment of sensory and motor characteristics was done. Inj. Dexmedetomidine as an adjuvant in spinal block, seems to be superior to intra-thecal MgSO4 as it has faster onset, longer duration of action, prolonged analgesia in comparison with Magnesium Sulphate without significant hemodynamic alterations. Dexmedetomidine, as an adjuvant to Inj. Bupivacaine intra-thecally in sub-arachnoid block, has faster onset, longer duration of action, prolonged analgesia in comparison with Magnesium Sulphate.

Spinal Anesthesia for Cesarean Section. Use of Hyperbaric Bupivacaine (10 mg) Combined with Different Adjuvants

Combination of local anesthetics (LA) with adjuvants for spinal anesthesia improves block quality and prolongs the duration of analgesia. It was evaluated the maternal effects and neonatal repercussions of sufentanil, morphine, and clonidine combined with hyperbaric bupivacaine for elective cesarean section. Prospective, randomized, blinded study of 96 patients allocated into four groups: Group I (no adjuvant), Group II (sufentanil 5.0 μg), Group III (morphine 100 μg), and Group IV (clonidine 75 μg). It was evaluated the onset and level of sensory block, perioperative analgesia, degree and recovery time of motor block, duration of analgesia, sedation, and maternal-fetal repercussions. The onset of blockade was significantly faster in groups with adjuvants compared with Group I. Patients in Groups I and III reported pain during the perioperative period. Duration of analgesia was significantly higher in Group II and time to motor block recovery was significantly higher in Group IV. Pruritus occurred in Groups II and III. Sedation was significant in Group IV and there was prolonged arterial hypotension in Group IV. Addition of sufentanil and clonidine to hyperbaric bupivacaine provided adequate anesthesia for cesarean section and good postoperative analgesia. Clonidine caused more perioperative sedation and longer time to motor block recovery. Pruritus was evident when opioids were used.

Intraoperative neurological event during cesarean section under spinal anesthesia with fentanyl and bupivacaine: Case report and review of literature

Neurological events similar to transient ischemic attack in a peripartum woman are uncommon. Cerebral complications of preeclampsia, thrombo-embolic phenomena, or high spinal can mimic such situations. Spinal anesthesia with local anesthetic and opioid is an established anesthetic technique for cesarean section. Although intrathecal opioids are safe for both the mother and fetus; some unusual complications such as dysphagia alone or associated with facial numbness, aphasia, have been reported. We report a case of transient aphonia and tingling sensation over the face without any dysphagia after intrathecal administration of bupivacaine and fentanyl for cesarean section.

Intrathecal Nalbuphine After Cesarean Delivery: Are We Ready?

Intrathecal Nalbuphine After Cesarean Delivery: Are We Ready?

Sensory block extension during combined spinal and epidural

Background and Objectives. During a combined spinal and epidural technique, extension of sensory block by epidural injection of saline or bupivacaine has been demonstrated and attributed to a volume effect or to the combination of a volume effect with a local anesthetic effect. This two-part study was designed to evaluate the time dependency of the volume effect and the local anesthetic effect on the mechanism of spinal block extension. Methods. We performed two prospective studies. Thirty patients were randomized in each study. A combined spinal and epidural was performed in a sitting position in all groups. The patients in the first study received 15 mg hyperbaric bupivacaine intrathecally and were placed supine 2 minutes after spinal injection. They received 10 mL epidural saline either 5 minutes after spinal (group A) or 20 minutes after spinal (group B) compared to a control group (group C). The patients in the second study received 12.5 mg hyperbaric bupivacaine intrathecally and were placed supine 5 minutes after spinal injection. They then received epidurally either 10 mL saline 7 minutes after spinal (group D) or 10 mL bupivacaine 7 minutes after spinal (group E) or nothing (group F). Sensory block levels were assessed by a loss of sensation to cold using ether. Results. In the first portion of this study, in group A, area under the curve of sensory block levels by time from 10 to 40 minutes after spinal injection, and maximum sensory block levels were significantly higher ( P < .05) compared to groups B and C. In the second portion of the study, sensory block levels were comparable at all times in the three groups. Conclusions. During a combined spinal and epidural technique with the use of hyperbaric bupivacaine, the volume effect is time dependent and is seen when epidural top up is done soon after spinal injection. This volume effect is abolished when patients are left seated for 5 minutes after spinal injection. The local anesthetic effect is not demonstrated when high sensory block levels are achieved by spinal injection.

Use of hyperbaric bupivacaine with epinephrine for spinal anesthesia in infants.

Previous studies have established the efficacy of spinal anesthesia in infants with hyperbaric lidocaine, hyperbaric tetracaine and isobaric and hyperbaric bupivacaine. Use of the commercially available hyperbaric spinal anesthesia solution of 0.75% bupivacaine in 8.25% dextrose has not heretofore been documented in this patient population. We present a series of 12 cases in which this hyperbaric bupivacaine solution with epinephrine was used for spinal anesthesia in children younger than 8 months of age.