The Effectiveness of Spinal Anaesthesia Using 0,5% Hyperbaric Bupivacaine 7,5 mg Plus 25 mcg Fentanyl Compared with 0,5% Hyperbaric Bupivacaine 12,5 mg in Caesarean Section
| Main Authors: | Bintartho, Agung, S, Pryambodho, Chandra, Susilo |
|---|---|
| Format: | application/pdf eJournal |
| Terbitan: |
The Indonesian Journal of Anesthesiology and Critical Care
, 2011
|
| Online Access: |
http://indonesia.digitaljournals.org/index.php/majacc/article/view/169 |
Daftar Isi:
- Background: Hypotension can be a serious threat to mother and baby in spinal anaesthesia during caesarean section. In order to decrease the incidence of hypotension, we can lower the dose of local anaesthesia and add lipophilic opioid to keep the quality of analgesia. This study tried to compare the used of 7,5 mg hyperbaric bupivacaine 0,5% plus 25 mcg fentanyl with 12,5 mg hyperbaric bupivacaine 0,5% only, a common spinal anaesthesia regiment used in Cipto Mangunkusumo General Hospital.Method: One hundred and eight parturient, who meet the inclusion criteria, divided into 2 groups, 54 parturient in group I received 7,5 mg hyperbaric bupivacaine 0,5% plus fentanyl 25 mcg, 54 parturient in group II received 12,5 mg hyperbaric bupivacaine 0,5% as a control group. Vital sign, hypotension, total ephedrine, sensory and motor block proï¬le, nausea and vomitting, pruritus, respiratory depression, and APGAR score were observed until 60 minutes after the spinal anaesthesia.Result: Hypotension was found in 13 parturient (24,1%) in group I and 23 parturient (42,6%) in group II. Difference between groups was statistically signiï¬cant. Mean of total ephedrine was found signiï¬cantly different (13,04 (±5,98) vs 5,38 (±1,38) mg). Sensory block at 60 minutes (T6 (T5-T8) vs T6 (T4-T8)) was found statistically different, time to reach maximal motor block (6,94 (±2,39) vs 4,33 (±2,89) minutes), maximum motor block (3 (2-3) vs 3 bromage scale), and motor block at 60 minutes (2 (1-3) vs 3 (2-3) bromage scale), were found signiï¬ cantly different. Other sensory block proï¬le, time to reach Th6 (3,94 (±1,4) vs 3,55 (±1,17) minutes), time to reach maximal sensory block (5,83 (±1,22) vs 5,94 (±0,91) minutes), and highest sensory block (T5 (T4-T6) vs T4 (T3-T6)), were not found different. Nausea and vomitting, pruritus, and APGAR score were not found different, and no respiratory depression was found. Conclusion: Spinal anaesthesia using combination of 7,5 mg hyperbaric bupivacaine 0,5% plus fentanyl 25 mcg is more effective compared with 12,5 mg hyperbaric bupivacaine 0,5% alone for caesarean section. It has an effective intraoperative analgesia and more stabile hemodynamic effect.Keywords: spinal anaesthesia, bupivacaine, fentanyl, caesarean section, hypotension