Hyperbaric Bupivacaine asAdjuvant in Spinal Anesthesia

Abstract

Background: Many causes affect the cephalic diffusion of the anesthetic solution in the subarachnoid space in the brain, between which the functional alterations inherent to pregnancy, basicity, dose and concentration of the local anesthetic stand out.

Objective: To evaluate the efficiency and complications or side effect of many concentrations of the mixture of both hyperbaric bupivacaine and sufentanil through the subarachnoid way in women with cesarean sections.

Methods: This study included 40 patients, with ASA I and II, defer to elective caesarean section with spinal anesthesia distributed into 2 groups, this is regarding to the anesthetic solution volume used: Group I (4 mL) and Group II (3 mL). In both groups, the local anesthetic used was hyperbaric bupivacaine (10 mg/2 mL) associated with sufentanil (5 µg/1 mL). In Group I, to obtain a volume of 4 mL, 1 mL of 0.9% physiological solution was added.

Results:  Expectancy, highest level of sensory block, degree, and time to reversion of motor block were similar in the two groups; the duration of analgesia was extended in Group I, with a significant difference in association to Group II. Adverse effects often happened in a comparable way in the two groups. The absence of maternal cardio circulatory alterations and neonatal repercussions was recorded.

Conclusion: Hyperbaric bupivacaine in a 10 mg dose associated with sufentanil in a 5 µg dose, with a volume of 4 mL, was more effective than the same association in a smaller volume (3 mL), giving better intraoperative and post-operative analgesia lacking maternal-fetal consequences.