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Study of equivalence: spinal bupivacaine 15mg versus bupivacaine 12mg with fentanyl 15μg for cesarean delivery.
MedLine Citation:
PMID:  22119634     Owner:  NLM     Status:  Publisher    
BACKGROUND: A safe and effective intrathecal dose of bupivacaine alone for cesarean delivery has not yet been established. This study tested the hypothesis that an intrathecal dose of hyperbaric bupivacaine 15mg would produce equivalent spinal anesthesia for cesarean delivery as the combination of hyperbaric bupivacaine 12mg and fentanyl 15μg. METHODS: This was a single center, double-blind, randomized clinical trial of equivalence. One hundred and thirty-eight healthy parturients scheduled for elective cesarean delivery were randomized to receive either intrathecal hyperbaric bupivacaine 15mg (Group B) or hyperbaric bupivacaine 12mg with fentanyl 15μg (Group BF). Parturients where asked to describe their degree of sensation during surgery using a four-point scale 20min after spinal injection. Secondary outcomes included the incidence of maternal side effects, maternal hemodynamics and the need for supplemental analgesia. RESULTS: There was no difference in the quality of anesthesia between the two groups. Sixty-eight of 69 and 69/69 patients in Group B and Group BF, respectively had anesthesia classified as successful (RR=1.01; 95% CI 0.85, 1.22). The only two secondary outcomes that were different between the groups were the largest change in mean arterial pressure (decrease of 40mmHg and 34mmHg for Group B and Group BF, respectively; P=0.004) and the incidence of nausea (59% and 35% for Group B and Group BF, respectively; P=0.006). CONCLUSION: There was no difference in the degree of sensation at 20min between Group B and Group BF. The only significant differences between the two techniques were a higher incidence of nausea and decrease in maternal blood pressure in Group B.
R A Meyer; A J Macarthur; K Downey
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-25
Journal Detail:
Title:  International journal of obstetric anesthesia     Volume:  -     ISSN:  1532-3374     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200430     Medline TA:  Int J Obstet Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Department of Anesthesia, Mount Sinai Hospital, Toronto, Canada.
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