Spinal Regional Anesthesia with Hypobaric Bupivacaine versus Isobaric Bupivacaine in Elective Cesarean Section
Autores/as
-
Yacnira Martínez
Servicio Canario de la Salud: Santa Cruz de Tenerife, España
https://orcid.org/0000-0003-0440-1875
DOI:
https://doi.org/10.70099/BJ/2024.01.04.18Palabras clave:
effectiveness, safety, spinal regional anesthesia, hypobaric bupivacaine, isobaric, elective cesarean sectionResumen
With regional anesthesia, there is an improvement in surgical results, which has beneficial effects on the perioperative period of the cesarean patient. Objective. To evaluate the effectiveness and safety of using regional spinal anesthesia with hypobaric bupivacaine vs. isobaric bupivacaine, both associated with fentanyl, in elective cesarean section. Method. A prospective, experimental, controlled, double-blind study was carried out on pregnant women undergoing elective cesarean section in the Gynecology and Obstetrics Service, at the Carlos Manuel de Céspedes Provincial General Hospital in Bayamo, Granma province, from September 2018 to December 2020 with the group I (Experimental or Study) which was administered 0.5% bupivacaine solution 1.5 ml (7.5 mg) plus 0.9% saline solution 1 ml (hypobaric technique) and a dose of fentanyl 25 mcg intrathecally and group II (control) which was administered a 0.5% isobaric bupivacaine solution 1.5 ml (7.5 mg) plus fentanyl 25 mcg. The Student, Chi-Square (Chi2), and Fisher's exact tests were used for categorical data. Results. No significant differences were found in the variables studied. Conclusions: Hypobaric bupivacaine associated with fentanyl was effective and safe by reducing the occurrence of negative hemodynamic changes and adverse effects, providing longer postoperative analgesia time and greater comfort for the patient undergoing elective cesarean section.
Citas
1. Ikeda, T., Kato, A., Bougaki, M. et al. A retrospective review of 10-year trends in general anesthesia for cesarean delivery at a university hospital: the impact of a newly launched team on obstetric anesthesia practice. BMC HealthServ Res 2020; 20, 421. https://doi.org/10.1186/s12913- 020-05314-2
2. Juang J, Gabriel RA, Dutton RP, Palanisamy A, Urman RD. Choice of anesthesia for cesarean delivery: an analysis of the National Anesthesia Clinical Outcomes Registry. AnesthAnalg. 2017; 124(6):1914–7.
3. Sugo, Y., Kubota, M., Niwa, H. et al. Moderate rate of implementation of spinal anesthesia for cesarean section: does it improve neonatal well-being? A case–control study. Sci Rep 2021: 11, 245. https://doi.org/10.1038/s41598-020-80666-7
4. Kim, W. H. et al. Comparison between general, spinal, epidural, and combined spinal-epidural anesthesia for cesarean delivery: a network meta-analysis. Int. J. Obstet. Anesth. 2019;37, 5–15
5. Juang, J., Gabriel, R. A., Dutton, R. P., Palanisamy, A. &Urman, R. D. Choice of anesthesia for cesarean delivery: an analysis of the national anesthesia clinical outcomes registry. Anesth. Analg. 2017: 124, 1914–1917.
6. Prabhu M, Clapp MA, McQuaid-Hanson E, et al. Liposomal bupivacaine block at the time of cesarean delivery to decrease postoperative pain: a randomized controlled trial. Obstet Gynecol. 2018; 132(1):70-78. doi:10.1097/AOG.0000000000002649
7. Hutchins JL, Renfro L, Orza F, Honl C, Navare S, Berg AA. The addition of intrathecal morphine to a transversus abdominis plane block with liposome bupivacaine provides more effective analgesia than transversus abdominis plane block with liposome bupivacaine alone: a retrospective study. Local RegAnesth. 2019; 12:7-13. doi:10.2147/LRA.S190225
8. Baker BW, Villadiego LG, Lake YN, et al. Transversus abdominis plane block with liposomal bupivacaine for pain control after cesarean delivery: a retrospective chart review. J Pain Res. 2018; 11:3109-3116. doi:10.2147/JPR.S184279
9. Mustafa HJ, Wong HL, Al-Kofahi M, Schaefer M, Karanam A, Todd MM. Bupivacaine pharmacokinetics and breast milk excretion of liposomal bupivacaine administered after cesarean birth. Obstet Gynecol. 2020; 136(1):70-76. doi:10.1097/AOG.0000000000003886
10. Dávila Cabo de Villa E. Anestesiología clínica. 2da edición. La Habana: Editorial Ciencias Médicas; 2014
11. Gutiérrez Alfaro LA. Eficacia comparativa del granisetron versus placebo como profilaxis de la hipotensión secundaria al bloqueo espinal en cesáreas electivas en el hospital Sermesa Bolonia durante el período de octubre a diciembre 2018. Tesis. Universidad Nacional Autónoma de Nicaragua. Managua, Nicaragua, marzo del 2019.
12. Chooi C, Cox JJ, Lumb RS, Middleton P, Chemali M, Emmett RS, Simmons SW, Cyna AM. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Cochrane Database of Systematic Reviews 2017, Issue 8. Art. No.: CD002251. DOI: 10.1002/14651858.CD002251.pub3. www.cochranelibrary.com
13. Lachicott Rodríguez Y, López Espinosa N, Donis Ramos M, Companioni Álvarez D, Ortiz Martínez N, Ferriol Giance Pd. Eficacia clínica de la bupivacaína al 0,5 % asociada a dosis de fentanilo en la anestesia espinal para cesárea. MediCiego [Internet]. 2017 [citado 15 Mar 2021];, 23(4):[aprox. 8 p.]. Disponible en: http://www.revmediciego.sld.cu/index.php/mediciego/article/view/693
14. Fuentes Ruiz A. Comparación de la bupivacaína isobárica con la bupivacaína hiperbárica en anestesia regional para cesárea en gestantes del hospital Manuel Núñez Butrón de Puno, año 2020. Universidad Nacional del Altiplano. Puno – Perú 2020
15. Aspajo Parede AJ. Análisis comparativo de las cesáreas en el hospital Apoyo Iquitos en dos periodos de estudio usando la clasificación de Robson. Tesis. Universidad Nacional de la Amazonia Peruana. Iquitos – Perú, 2017
16. Carreño B, Castillo V, Aichele D, Marshall M, Caceres D, et al. Tasa de cesáreas según la clasificación de Robson: análisis comparativo entre dos hospitales universitarios. RevChilObstetGinecol. 2018 [visitado 2019 ene 18];83(4):416-4426. Disponible en: https://scielo.conicyt.cl/pdf/rchog/v83n4/0717-7526-rchog-83-04-0415.pdf
17. Smithies M, Woolcott C, Brock J, Maguire B, Allen V. Factors associated with trial of labour and mode of delivery in Robson Group 5: A select group of women with previous caesarean section. J ObstetGynaecol Can. 2018; 40(6):704-11. https://doi.org/10.1016/j.jogc.2017.10.026
18. Efficacy and safety of Exparel versus standard of care (SoC) in subjects undergoing elective cesarean section (CHOICE). U.S. National Library of Medicine. Updated January 13, 2020. Accessed July 15, 2020. https://clinicaltrials.gov/ct2/show/NCT03853694?id=NCT03176459 OR NCT02353754 OR NCT03853694&draw=2&rank=1&load=cart
19. Abe, H. et al. Association between mode of anaesthesia and severe maternal morbidity during admission for scheduled Caesarean delivery: a nationwide population-based study in Japan, 2010–2013. Br. J. Anaesth. 2018; 120, 779–789.
20. Macones GA, Caughey AB, Wood SL, et al. Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) Society recommendations (part 3). Am J Obstet Gynecol. 2019; 221(3):247.e1-247.e9. doi:10.1016/j.ajog.2019.04.012
21. Evaluate the safety and efficacy of Exparel when administered via infiltration into the TAP vs. bupivacaine alone in subjects undergoing elective C-sections (C-Section). S. National Library of Medicine. Updated April 22, 2019. Accessed July 15, 2020.
https://clinicaltrials.gov/ct2/show/NCT03176459?id=NCT03176459 OR NCT02353754 OR NCT03853694&draw=2&rank=2&load=cart
22. Malhotra A, Singh U, Singh M R, Sood D, Grewal A, Mahajan A. Efficacy of premixed versus succedent administration of fentanyl and bupivacaine in subarachnoid block for lower limb surgeries: A randomised control trial. Indian J Anaesth 2020;64, Suppl S3:175-9
23. Rai A, Bhutia MP. Dexmedetomidine as an additive to spinal anaesthesia in orthopaedic patients undergoing lower limb surgeries: A randomized clinical trial comparing two different doses of dexmedetomidine. J ClinDiagn Res 2017;11:9-12. Back tocitedtext no. 15
24. Kiruthika B, Cheran K, Suresh V. Comparison of intrathecal fentanyl with bupivacaine administered as a mixture and sequentially in lower abdominal surgeries. Asia Pac J Res 2017;I: 52-7.
25. Gaddam M. Comparison of intrathecal clonidine and hyperbaric bupivacaine administered as premixed form or sequentially for ceasarean section- A randomized controlled study. IRPMS 2017;3:13-21.
26. Álvarez Cerrón MJ. Eficacia clínica de la bupivacaína hiperbarica al 0,5 % asociada a dosis de fentanilo en la anestesia espinal para cesárea en el hospital Chancay y SBS. Tesis. Universidad Peruana Cayetano Heredia. LIMA – PERÚ, 2019
27. Raza H, Ahmed B, Basar S y Ali A. Comparison of the hemodynamic changes as seen in patients undergoing cesarean section with hyperbaric bupivacaine versus isobaric bupivacaine. 2016
28. Espín-González R, Cabezas-Poblet B, Cabezas-Poblet M, Mur-Villar N. Anestesia epidural en la cesárea iterativa..Medisur [revista en Internet]. 2007 [citado 2020 Nov 30]; 1(1):[aprox. 7 p.]. Disponible en: http://www.medisur.sld.cu/index.php/medisur/article/view/2
29. Sng B, Siddiqui F, Leong W, Assam P, Chan E, Tan K, Sia A. Hyperbaric versus isobaric bupivacaine for spinal anesthesia for caesarean section. Cochrane Database of Systematic Reviews 2016, Disponible en: https://doi.org/10.1002/14651858.CD005143.pub3
Descargas
Publicado
Cómo citar
Número
Sección
Categorías
Licencia
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Authors who publish with BioNatura Journal agree to the following terms: Authors retain copyright and grant the BioNatura Institutional Publishing Consortium (BIPC) right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). This allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
