title: Spinal anesthesia for cesarean section. Use of hyperbaric bupivacaine (10mg) combined with different adjuvants.
abstract: OBJECTIVE
  Combination of local anesthetics (LA) with adjuvants for spinal anesthesia improves block quality and prolongs the duration of analgesia. It was evaluated the maternal effects and neonatal repercussions of sufentanil, morphine, and clonidine combined with hyperbaric bupivacaine for elective cesarean section.
  
  
  METHODS
  Prospective, randomized, blinded study of 96 patients allocated into four groups: Group I (no adjuvant), Group II (sufentanil 5.0 μg), Group III (morphine 100 μg), and Group IV (clonidine 75 μg). It was evaluated the onset and level of sensory block, perioperative analgesia, degree and recovery time of motor block, duration of analgesia, sedation, and maternal-fetal repercussions.
  
  
  RESULTS
  The onset of blockade was significantly faster in groups with adjuvants compared with Group I. Patients in Groups I and III reported pain during the perioperative period. Duration of analgesia was significantly higher in Group II and time to motor block recovery was significantly higher in Group IV. Pruritus occurred in Groups II and III. Sedation was significant in Group IV and there was prolonged arterial hypotension in Group IV.
  
  
  CONCLUSIONS
  Addition of sufentanil and clonidine to hyperbaric bupivacaine provided adequate anesthesia for cesarean section and good postoperative analgesia. Clonidine caused more perioperative sedation and longer time to motor block recovery. Pruritus was evident when opioids were used.
authors.affiliation: Department of Anesthesiology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), SP, Brazil. franklinbraga@terra.com.br
authors.forename: Angélica Assunção
authors.initials: AA
authors.lastname: Braga
authors.forename: José Aristeu F
authors.initials: JA
authors.lastname: Frias
authors.forename: Franklin S
authors.initials: FS
authors.lastname: Braga
authors.forename: Glória B
authors.initials: GB
authors.lastname: Potério
authors.forename: Eunice S
authors.initials: ES
authors.lastname: Hirata
authors.forename: Nathalia A
authors.initials: NA
authors.lastname: Torres
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D002045:Bupivacaine