Document Type : Original Article
Authors
1
Associate Professor, Department of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2
Assistant Professor, Department of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3
Resident of Anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Abstract
Introduction: Hypotension is the most complication of spinal anesthesia in cesarean delivery, which cause various side effects such as nausea, vomiting, drowsiness and increased risk of aspiration is mother. Opioids have synergistic effects on local anesthetics drugs and increase sensory block duration without increase sympathetic block and also may reduce hypotension episodes. The aim of this study was evaluating the application of different dosage of bupivacaine in combination with intrathecal sufentanil in cesarean delivery and its effects on maternal hemodynamic during cesarean section, level of sympathetic block, block duration and neonatal Apgar.
Methods: This double blind clinical trial was conducted on 45 patients between 18-40 years old who were candidate for cesarean section and set in class 1 of Anesthesia Society of America classification (ASA1). Patients were divided into three groups (A, B, C). Each group received 3µg sufentanil in combination with 6, 8 and 10 mg bupivacaine. Hypotension, nausea, vomiting, level and duration of block and 1 and 5 minutes Apgar scores, satisfaction level and maximum sedation level were assessed. After normalized controlling, ANOVA or Kruskal-Wallis tests were used to compare 3 groups. P value less than 0.05 was considered significant.
Results: The time to reach peak block level and latest block level had not significant differences in three groups (p<0.05). Hypotension (p=0.005), ephedrine consumption total dose (p=0.002) and nausea (p=0.001) had statistically significant differences among groups. Motor block degree, intraoperative pain, patients' satisfaction and 1 and 5 minutes Apgar scores had not statistically significant differences among groups (p>0.05).
Conclusion: Application of 3µg sufentanil in combination with bupivacaine in spinal anesthesia for cesarean delivery reduces bupivacaine dose for satisfactory sensory block to 6 mg with less hypotension, nausea, vomiting without any adverse effect on Apgar scores.
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