Details

Autor(en) / Beteiligte

• Xiao, Fei
• Xu, Wen-Ping
• Zhang, Xiao-Min
• Zhang, Yin-Fa
• Wang, Li-Zhong
• Chen, Xin-Zhong

Titel

ED50 and ED95 of Intrathecal Bupivacaine Coadministered with Sufentanil for Cesarean Delivery Under Combined Spinal-epidural in Severely Preeclamptic Patients

Ist Teil von

• Chinese medical journal, 2015-02, Vol.128 (3), p.285-290

Ort / Verlag

India: Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China

Erscheinungsjahr

2015

Quelle

EZB Free E-Journals

Beschreibungen/Notizen

• Background： Spinal anesthesia was considered as a reasonable anesthetic option in severe preeclampsia when cesarean delivery is indicated, and there is no indwelling epidural catheter or contraindication to spinal anesthesia. However, the ideal dose of intrathecal bupivacaine has not been quantified for cesarean delivery for severe preeclamptic patients. This study aimed to determine the ED50 and ED95 of intrathecal bupivacaine for severely preeclamptic patients undergoing elective cesarean delivery. Methods： Two hundred severely preeclamptic patients are undergoing elective cesarean delivery under combined spinal-epidural anesthesia enrolled in this randomized, double-blinded, dose-ranging study. Patients received 4 rag, 6 mg, 8 mg, or 10 mg intrathecal hyperbaric bupivacaine with 2.5 μg sufentanil. Successful spinal anesthesia was defined as a T6 sensory level achieved within 10 minutes after intrathecal drug administration and/or no epidural supplement was required during the cesarean section. The ED50 and ED95 were calculated with a logistic regression model. Results： ED90 and ED95 ofintrathecal bupivacaine for successful spinal anesthesia were 5.67 mg （95% confidence interval [C/]： 5.20-6.10 mg） and 8.82 mg （95% CI： 8.14-9.87 mg） respectively. The incidence of hypotension in Group 8 mg and Group 10 mg was higher than that in Group 4 mg and Group 6 mg （P 〈 0.05）. The sensory block was significantly different among groups 10 minutes after intrathecal injection （P 〈 0.05）. The use of lidocaine in Group 4 mg was higher than that in other groups （P 〈 0.05）. The use of phenylephrine in Group 8 mg and Group 10 mg was higher than that in the other two groups （P 〈 0.05）. The lowest systolic blood pressure before the infant delivery of Group 8 mg and Group 10 mg was lower than the other two groups （P 〈 0.05）. The satisfaction of muscle relaxation in Group 4 mg was lower than other groups （P 〈 0.05）. There was no significant difference in patients＇ satisfaction and the newborns＇ Apgar score and the blood gas analysis of umbilical artery serum （P 〉 0.05）. Conclusion： Our study showed that the EDs0 and ED~ of intrathecal bupivacaine for severely preeclamptic patients undergoing elective cesarean delivery were 5.67 mg and 8.82 mg, respectively. In addition, decreasing the dose of intrathecal bupivacaine could reduce the incidence of maternal hypotension.