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Influence of injection rate of hyperbaric bupivacaine on spinal block in parturients: a randomized trial.
Can J Anaesth. 2007 Apr; 54(4):290-5.CJ

Abstract

PURPOSE

A prospective, randomized, double-blind clinical trial was undertaken to determine whether a tenfold difference in the rate of intrathecal injection of bupivacaine would affect sensory block level in parturients. Secondary outcomes included onset of block and the incidence of hypotension and nausea.

METHODS

Following Research Ethics Board approval, 90 ASA I and II term parturients scheduled for Cesarean delivery were randomized to receive either fast injection (over four seconds, Group F) or slow injection (over 40 sec, Group S) of 0.75% hyperbaric bupivacaine 12 mg plus morphine 200 microg. Sensory block, motor block, and blood pressure were assessed every minute for the first 15 min, then every five minutes for the next 20 min. All occurrences of nausea, hypotension (decrease in systolic blood pressure > 30%) and ephedrine requirements were recorded.

RESULTS

Forty-three patients in Group F and 42 patients in Group S completed the study. No differences in maximum sensory block height (Group F = median T2, interquartile range [T2-T4], Group S = T3 [T2-T4], P = 0.077) or time to achieve block height (F = 9.3 +/- 4.3 min, S = 9.7 +/- 4.7, P = 0.64) were observed. The frequencies of hypotension (Group F = 35/43, Group S = 32/42, P = 0.56), ephedrine utilization (Group F = 32/43, Group S = 26/42, P = 0.21) and nausea (Group F = 15/43, Group S = 16/42, P = 0.76) were similar.

CONCLUSION

Rapid intrathecal injection of hyperbaric bupivacaine does not affect spread of spinal anesthesia or the incidence of hypotension and nausea in parturients.

Authors+Show Affiliations

Department of Anesthesia, Schulich School of Medicine, University of Western Ontario, St.Joseph's Hospital, 268 Grosvenor St., London, Ontario N6A 4L6, Canada. isingh@uwo.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17400981

Citation

Singh, Sudha Indu, et al. "Influence of Injection Rate of Hyperbaric Bupivacaine On Spinal Block in Parturients: a Randomized Trial." Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, vol. 54, no. 4, 2007, pp. 290-5.
Singh SI, Morley-Forster PK, Shamsah M, et al. Influence of injection rate of hyperbaric bupivacaine on spinal block in parturients: a randomized trial. Can J Anaesth. 2007;54(4):290-5.
Singh, S. I., Morley-Forster, P. K., Shamsah, M., & Butler, R. (2007). Influence of injection rate of hyperbaric bupivacaine on spinal block in parturients: a randomized trial. Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie, 54(4), 290-5.
Singh SI, et al. Influence of Injection Rate of Hyperbaric Bupivacaine On Spinal Block in Parturients: a Randomized Trial. Can J Anaesth. 2007;54(4):290-5. PubMed PMID: 17400981.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of injection rate of hyperbaric bupivacaine on spinal block in parturients: a randomized trial. AU - Singh,Sudha Indu, AU - Morley-Forster,Patricia K, AU - Shamsah,Mohammed, AU - Butler,Ron, PY - 2007/4/3/pubmed PY - 2007/7/18/medline PY - 2007/4/3/entrez SP - 290 EP - 5 JF - Canadian journal of anaesthesia = Journal canadien d'anesthesie JO - Can J Anaesth VL - 54 IS - 4 N2 - PURPOSE: A prospective, randomized, double-blind clinical trial was undertaken to determine whether a tenfold difference in the rate of intrathecal injection of bupivacaine would affect sensory block level in parturients. Secondary outcomes included onset of block and the incidence of hypotension and nausea. METHODS: Following Research Ethics Board approval, 90 ASA I and II term parturients scheduled for Cesarean delivery were randomized to receive either fast injection (over four seconds, Group F) or slow injection (over 40 sec, Group S) of 0.75% hyperbaric bupivacaine 12 mg plus morphine 200 microg. Sensory block, motor block, and blood pressure were assessed every minute for the first 15 min, then every five minutes for the next 20 min. All occurrences of nausea, hypotension (decrease in systolic blood pressure > 30%) and ephedrine requirements were recorded. RESULTS: Forty-three patients in Group F and 42 patients in Group S completed the study. No differences in maximum sensory block height (Group F = median T2, interquartile range [T2-T4], Group S = T3 [T2-T4], P = 0.077) or time to achieve block height (F = 9.3 +/- 4.3 min, S = 9.7 +/- 4.7, P = 0.64) were observed. The frequencies of hypotension (Group F = 35/43, Group S = 32/42, P = 0.56), ephedrine utilization (Group F = 32/43, Group S = 26/42, P = 0.21) and nausea (Group F = 15/43, Group S = 16/42, P = 0.76) were similar. CONCLUSION: Rapid intrathecal injection of hyperbaric bupivacaine does not affect spread of spinal anesthesia or the incidence of hypotension and nausea in parturients. SN - 0832-610X UR - https://www.unboundmedicine.com/medline/citation/17400981/Influence_of_injection_rate_of_hyperbaric_bupivacaine_on_spinal_block_in_parturients:_a_randomized_trial_ L2 - https://doi.org/10.1007/BF03022774 DB - PRIME DP - Unbound Medicine ER -