Spinal block with 10 mg of hyperbaric bupivacaine associated with 5 microg of sufentanil for cesarean section. Study of different volumes.
OBJECTIVE
Several factors affect the cephalad dispersion of the anesthetic solution in the subarachnoid space; among them, physiological changes of pregnancy and the dose and volume of the local anesthetics should be mentioned. The objective of this study was to assess the effectivity and side effects of different volumes of the subarachnoid administration of the association of hyperbaric bupivacaine and sufentanil in cesarean sections.


METHODS
Forty patients, ASA I and II, undergoing elective cesarean section under spinal block were divided in two groups, according to the volume of the anesthetic solution: Group I (4 mL) and Group II (3 mL). The association of hyperbaric bupivacaine (10 mg(2) mL) and sufentanil (5 microg-1 mL) was used in both groups. In Group I, 1 mL of NS was added to the solution to achieve the volume of 4 mL. The following parameters were evaluated: latency of the blockade; upper limit of the sensorial blockade; degree of motor blockade; time for regression of the motor blockade; total duration of analgesia; maternal side effects; and neonatal repercussions.


RESULTS
Latency, the upper limit of the sensorial blockade, and the degree and time for regression of the motor blockade were similar in both groups; duration of analgesia was greater in Group I than in Group II, which was statistically significant. The incidence of side effects was similar in both groups. Maternal cardiocirculatory changes and neonatal repercussions were not observed.


CONCLUSIONS
Four milliliter of anesthetic solution composed of hyperbaric bupivacaine, 10 mg, associated with 5 microg of sufentanil was more effective than 3 ml of the same solution, providing better intra-and postoperative analgesia without maternal-fetal repercussions.
Braga
Angélica de Fátima de Assunção
Ade F
Seção de Anestesia, CAISM, UNICAMP.
Frias
José Aristeu Fachini
JA
Braga
Franklin Sarmento da Silva
FS
Pinto
Daniela Roncoletta da Silva
DR
D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D011247:Pregnancy; D017409:Sufentanil / Q000008:administration & dosage*
D000759:Adjuvants, Anesthesia; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D017409:Sufentanil; D002045:Bupivacaine