Hyperbaric Bupivacaine, Isobaric Bupivacaine, Lower Abdominal Surgery, Spinal Anesthesia
Conditions
Brief summary
The aim of this study is to compare the effects of intrathecal injection of hyperbaric bupivacaine versus injection of hyperbaric and isobaric bupivacaine in patients undergoing lower abdominal surgery.
Detailed description
Spinal anesthesia is one of the most commonly used nerve block procedures for surgical operations involving the lower abdomen, the perineum, and the lower limbs, owing to its quick effect and cost-effectiveness. Spinal anesthesia is advantageous in that it uses a small dose of anesthesia, is simple to perform, and offers a rapid onset of action, reliable surgical analgesia, and good muscle relaxation. The Baricity of a solution is defined as the ratio of the density of the solution to that of the cerebrospinal fluid (CSF). The most common anesthetic used for SA in obstetric and non-obstetric surgery is bupivacaine, which can be formulated as an isobaric or hyperbaric solution. Baricity differences between spinal anesthetic solutions are thought to affect hemodynamic parameters and distribution within the subarachnoid space, which may, in turn, affect the onset, extent, and duration of sensory block as well as side effects. Spinal anesthesia has been linked to different adverse effects, out of which hypotension is most common complication. The incidence of hypotension is 25-75% in general population. Factors that increase the risk of hypotension include patient factors (advanced age, pregnancy, obesity, diabetes mellitus, hypertension, and anemia) and technical factors such as a block level at or above T5, use of opioids during premedication, and high local anesthetic dosages.
Interventions
DRUGGroup A (hyperbaric bupivacaine)
Patients were injected intrathecally with 20 mg hyperbaric bupivacaine 0.5% solution
DRUGGroup B (Mixture of Hyperbaric and Isobaric Bupivacaine)
Patients received 10 mg hyperbaric bupivacaine and 10 mg isobaric bupivacaine 0,5 % solution
Sponsors
Helwan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18-65 years old. * Both sexes. * American Society of Anaesthesia (ASA) I to II. * Undergoing lower abdominal or urological surgery under spinal anesthesia
Exclusion criteria
* Allergy to amide. * Patients with a significant history of substance abuse. * Patients with diabetes mellitus, neurological or cardiovascular diseases. * Patients with neuromuscular diseases. * Pregnant patients.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of hypotension | 3 hours post-injection | Blood pressure was recorded using standard non-invasive monitors at 5, 10, 15, 20, 25, 30, 45, and 60 min, then hourly until 3 h post-injection. Hypotension was defined as a decrease in mean arterial pressure of more than 30% from baseline. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate | 3 hours post-injection | Heart rate was recorded using standard non-invasive monitors at 5, 10, 15, 20, 25, 30, 45, and 60 min, then hourly until 3 h post-injection. |
| Mean arterial pressure (MAP) | 3 hours post-injection | Mean arterial pressure was recorded using standard non-invasive monitors at 5, 10, 15, 20, 25, 30, 45, and 60 min, then hourly until 3 h post-injection. |
Countries
Egypt
Outcome results
None listed