Publication: The effect of baricity of intrathecal bupivacaine for elective cesarean delivery on maternal cardiac output: a randomized study
Issued Date
2020-01-01
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ISSN
15323374
0959289X
0959289X
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2-s2.0-85094629241
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Obstetric Anesthesia. (2020)
Suggested Citation
P. Limratana, T. Kiatchai, P. Somnuke, P. Prapakorn, S. Suksompong The effect of baricity of intrathecal bupivacaine for elective cesarean delivery on maternal cardiac output: a randomized study. International Journal of Obstetric Anesthesia. (2020). doi:10.1016/j.ijoa.2020.07.011 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/60098
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Title
The effect of baricity of intrathecal bupivacaine for elective cesarean delivery on maternal cardiac output: a randomized study
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Abstract
© 2020 Elsevier Ltd Background: Hemodynamic instability during spinal anesthesia for cesarean delivery is associated with adverse maternal and fetal outcomes. Plain and hyperbaric bupivacaine are commonly used for cesarean delivery, however, their distinctive pharmacologic properties may affect maternal hemodynamic profiles differently. The aim of this study was to compare hemodynamic profiles using a suprasternal Doppler cardiac output (CO) monitor in healthy term parturients randomized to receive plain or hyperbaric bupivacaine for cesarean delivery. Methods: One hundred sixty-eight healthy parturients scheduled for elective cesarean delivery were randomly assigned to receive 10.9 mg of intrathecal 0.5% plain or hyperbaric bupivacaine, both with 0.2 mg morphine. The primary outcome was CO change after spinal anesthesia. The Secondary outcomes were the incidence of hypotension, vasopressor use, and conversion to general anesthesia. Results: The mean (±SD) CO at baseline, 1 min and 5 min after spinal anesthesia, and after placental delivery was 4.6 ± 1.2, 5.4 ± 1.3, 5.1 ± 1.4, and 6.4 ± 1.7 L/min in the plain bupivacaine, and 4.5 ± 1.1, 5.2 ± 1.3, 4.9 ± 1.3, and 6.2 ± 1.9 L/min in the hyperbaric bupivacaine group. There were no significant differences in CO, mean arterial pressure, or systemic vascular resistance. Incidences of hypotension, vasopressor and supplemental analgesic use, and conversion to general anesthesia, were not different between groups. Conclusions: Cardiac output changes after plain or hyperbaric bupivacaine were not different in term parturients undergoing spinal anesthesia for cesarean delivery. Further studies comparing block quality and the rate of conversion to general anesthesia are required.