Document Detail


Low dose of intrathecal hyperbaric bupivacaine combined with epidural lidocaine for cesarean section--a balance block technique.
MedLine Citation:
PMID:  8109762     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The present study was designed to develop a combined spinal/epidural anesthetic technique for cesarean section. We compared the effects of different doses of intrathecal hyperbaric bupivacaine (0.5%) combined with epidural lidocaine (2%). We attempted to interrupt somatosensory pathways with spinal anesthesia but to avoid acute high thoracic sympathetic block. The visceral afferent pathways were to be blocked relatively slowly with epidural lidocaine. Eighty term parturients were randomly divided into four groups. In Group A, 2.5 mg of bupivacaine intrathecally combined with 22.2 +/- 4.6 mL of lidocaine epidurally provided insufficient muscle relaxation. In Group B, 5 mg of bupivacaine with 10.1 +/- 2.0 mL of lidocaine resulted in satisfactory anesthesia with rapid onset and minimum side effects. Anesthesia in Group C (7.5 mg of bupivacaine) and Group D (10 mg of bupivacaine) was mostly due to spinal block. Complications included hypotension, nausea, and dyspnea. The combined spinal/epidural technique, using 5 mg of bupivacaine and with sufficient epidural lidocaine to reach a T4 level, had the advantages of both spinal and epidural anesthesia with few of the complications of either.
Authors:
S Z Fan; L Susetio; Y P Wang; Y J Cheng; C C Liu
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  78     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-03-24     Completed Date:  1994-03-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  474-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Epidural*
Anesthesia, Obstetrical*
Bupivacaine / administration & dosage*
Cesarean Section*
Female
Humans
Injections, Spinal
Lidocaine*
Pregnancy
Surgical Procedures, Elective
Chemical
Reg. No./Substance:
137-58-6/Lidocaine; 2180-92-9/Bupivacaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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