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HYPERBARIC SPINAL BUPIVACAINE COMBINED WITH MORPHINE AND FENTANYL FOR CESAREAN DELIVERY: COMPARISON OF THE THREE DOSES OF HYPERBARIC BUPIVACAINE AND MOTOR BLOCK
Author(s): ,
Ajimi, J.*
Affiliations:
Tokai University Hachioji Hospital, Anesthesiology, Hachioji, Japan
,
Masuda, R.
Affiliations:
Tokai University Hachioji Hospital, Anesthesiology, Hachioji, Japan
,
Soejima, A.
Affiliations:
Tokai University Hachioji Hospital, Anesthesiology, Hachioji, Japan
,
Hosoi, S.
Affiliations:
Tokai University Hachioji Hospital, Anesthesiology, Hachioji, Japan
,
Sakamoto, R.
Affiliations:
Tokai University Hachioji Hospital, Anesthesiology, Hachioji, Japan
,
Murata, T.
Affiliations:
Tokai University Hachioji Hospital, Anesthesiology, Hachioji, Japan
,
Suzuki, Y.
Affiliations:
Tokai University Hachioji Hospital, Anesthesiology, Hachioji, Japan
Suzuki, T.
Affiliations:
Tokai University School of Medicine, Anesthesiology, Isehara, Japan
ESRA Academy. Ajimi J. Sep 13, 2017; 190805; 159 Topic: Caesarean Section
Junko Ajimi
Junko Ajimi

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Abstract
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Background and Aims:

To prevent deep vein thrombosis/pulmonary infarction in the perioperative period, the early recovery of the motor function of the lower extremities is essential after a cesarean section. Single-shot spinal anesthesia (SSS) using intrathecal bupivacaine- fentanyl-morphine is successfully used for improvement of perioperative analgesic quality and for anticoagulant therapy. We studied minimal required dose of bupivacaine for early mobilization.

Methods:

We conducted a retrospective study in 64 patients who had a planned cesarean section and received a spinal anesthesia in which, after the placement of an epidural catheter, hyperbaric bupivacaine combined with morphine 0.1 mg and fentanyl 20 μg was intrathecally administered. Three bupivacaine-dose groups, 10mg (n=21), 8mg (n=21) and 6mg (n=22) were compared. We investigated the maximum analgesic level, the doses of the pressors, the recovery time from the motor block of the lower extremities, and the postoperative analgesia. In the cases of insufficient analgesia by SSS only, epidural ropivacaine was administered and dropped out from the comparison objects in regarding to recovery time of motor blockade.

Results:

The three groups shared similar background factors. Recovery time significantly related to dose of bupivacaine. Patients got full motor recovery within 4hours in group 6mg and 8mg. One patient in Group 8mg and four patients in Group 6mg failed SSS and required epidural infusion during the operation.

Conclusions:

With an epidural  catheter backup, low-dose bupivacaine of 8mg with opioid supplementation was effective in terms of the motor function of the lower extremities.

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