[Hyperbaric bupivacaine: a randomized double-blind trial of different doses with or without fentanyl for cesarean section under spinal anesthesia].
OBJECTIVE
To compare the effects of spinal anesthesia with different doses of hyperbaric bupivacaine with or without fentanyl in patients undergoing cesarean section.


METHODS
Prospective study enrolling 50 ASA 1-2 patients undergoing cesarean section, randomized to 5 treatment groups. Groups A, B, C, and D received 15 microg of fentanyl and group X received no fentanyl. The doses of hyperbaric bupivacaine given in each group were as follows: 10 mg in Group A, 11 mg in group B, 12 mg in group C, 13 mg in group D, and 14 mg in group X.


RESULTS
Patients in groups A and B had greater hemodynamic stability than patients in groups C, D, or X (P < 0.05). The incidence of hypotension was 70% in group C and 80% in groups D and X. The sensory block reached level T4 in groups D and X and the motor block was complete in all cases. Postoperative analgesia lasted longer in group D with a mean (SD) duration of 202 (25) minutes than in group X with a mean duration of 194 (19) minutes. Assessment on a visual analog scale was under 3 in all groups except group A, where 2 patients required administration of propofol.


CONCLUSIONS
Acceptable operative conditions with a low incidence of hypotension are provided with an 11 mg dose of hyperbaric bupivacaine.
Bernat García
J
J
Servicio de Anestesiología y Reanimación Materno-Infantil, Hospital La Fe, Valencia. josefabernat@hotmail.com
Gallego García
J
J
Abengochea Cotaina
A
A
D000328:Adult; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002045:Bupivacaine / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004357:Drug Synergism; D004809:Ephedrine / Q000627:therapeutic use; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D005440:Fluid Therapy; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000139:chemically induced / Q000188:drug therapy / Q000517:prevention & control; D008297:Male; D009068:Movement / Q000187:drug effects; D009294:Narcotics / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology; D010146:Pain / Q000517:prevention & control; D011247:Pregnancy; D011292:Premedication; D011312:Pressure; D011446:Prospective Studies; D012677:Sensation / Q000187:drug effects
D000779:Anesthetics, Local; D009294:Narcotics; D004809:Ephedrine; D005283:Fentanyl; D002045:Bupivacaine