Comparison of the Effects of Two Different Low-Doses of Isobaric Bupivacaine on Intraoperative Hemodynamics under Spinal Anaesthesia during Caesarean Section: A Randomized Controlled Trial

Background: The objective of this study was to conduct a randomized controlled trial in order to examine the hemodynamic impacts of two different doses of intrathecal isobaric bupivacaine (5 mg and 7 mg) when combined with 15 µg fentanyl in the context of patients undergoing caesarean section under...

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Main Authors: Aysenur Dostbil, Canan Atalay, Ilker Ince, Mehmet Aksoy, Ozgur Ozmen, Kamber Kasali, Omer Erkan Yapca, Tugberk Kucun, Ayse Nur Aksoy, Gamze Nur Cimilli Senocak
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Language:English
Published: IMR Press 2023-11-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/50/11/10.31083/j.ceog5011241
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author Aysenur Dostbil
Canan Atalay
Ilker Ince
Mehmet Aksoy
Ozgur Ozmen
Kamber Kasali
Omer Erkan Yapca
Tugberk Kucun
Ayse Nur Aksoy
Gamze Nur Cimilli Senocak
author_facet Aysenur Dostbil
Canan Atalay
Ilker Ince
Mehmet Aksoy
Ozgur Ozmen
Kamber Kasali
Omer Erkan Yapca
Tugberk Kucun
Ayse Nur Aksoy
Gamze Nur Cimilli Senocak
author_sort Aysenur Dostbil
collection DOAJ
description Background: The objective of this study was to conduct a randomized controlled trial in order to examine the hemodynamic impacts of two different doses of intrathecal isobaric bupivacaine (5 mg and 7 mg) when combined with 15 µg fentanyl in the context of patients undergoing caesarean section under combined spinal epidural anesthesia. Methods: Eighty patients with American Society of Anesthesiologists physical status I and II, aged between 16–50 years, who would undergo elective caesarean section under combined spinal epidural anaesthesia were randomly allocated to Group A and Group B (n = 40, for each group). Group A patients received a solution containing 5 mg isobaric bupivacaine + 15 µg fentanyl (1.3 mL), while Group B patients received a solution containing 7 mg isobaric bupivacaine + 15 µg fentanyl (1.7 mL) intrathecally. Incidences of hypotension, intraoperative systolic blood pressure, diastolic blood pressure, heart rate, motor block resolving time, and analgesia duration were recorded. Results: Group A had a substantially lower incidence of hypotension than Group B (p = 0.022). Patients in Group B had significantly lower systolic blood pressure values at the 6th, 8th, 10th, 12th, 14th, 15th, and 30th minutes of the surgery compared to Group A (p = 0.012, p = 0.014, p = 0.005, p = 0.016, p < 0,001, p = 0.002, and p = 0.011; respectively). Both groups had similar diastolic blood pressure and heart rate values during surgery (p > 0.05). The motor block resolving time and analgesia duration were longer in Group B compared to Group A (p < 0.001 for both). Two (5%) patients in Group A and ten (25%) patients in Group B experienced postoperative itching (p = 0.012). Conclusions: We concluded that combining 5 mg isobaric bupivacaine with 15 mcg of fentanyl administered intrathecally provides adequate anaesthesia while maintaining better hemodynamic stability in patients undergoing caesarean section. Clinical Trial Registration: The study has been registered with registration number NCT05136040 on https://classic.clinicaltrials.gov/ct2/results?cond=&term=+NCT05136040&cntry=&state=&city=&dist=.
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spelling doaj-art-a4953c9b8e1d45dfbbbb9f539598324d2025-08-20T03:38:14ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-11-01501124110.31083/j.ceog5011241S0390-6663(23)02186-3Comparison of the Effects of Two Different Low-Doses of Isobaric Bupivacaine on Intraoperative Hemodynamics under Spinal Anaesthesia during Caesarean Section: A Randomized Controlled TrialAysenur Dostbil0Canan Atalay1Ilker Ince2Mehmet Aksoy3Ozgur Ozmen4Kamber Kasali5Omer Erkan Yapca6Tugberk Kucun7Ayse Nur Aksoy8Gamze Nur Cimilli Senocak9Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, 25240 Erzurum, TurkeyDepartment of Anesthesiology and Reanimation, Ataturk University School of Medicine, 25240 Erzurum, TurkeyAnesthesiology Clinical Research Office, Ataturk University School of Medicine, 25240 Erzurum, TurkeyDepartment of Anesthesiology and Reanimation, Ataturk University School of Medicine, 25240 Erzurum, TurkeyDepartment of Anesthesiology and Reanimation, Ataturk University School of Medicine, 25240 Erzurum, TurkeyAnesthesiology Clinical Research Office, Ataturk University School of Medicine, 25240 Erzurum, TurkeyDepartment of Obstetrics and Gynecology, Ataturk University School of Medicine, 25240 Erzurum, TurkeyDepartment of Anesthesiology and Reanimation, Ataturk University School of Medicine, 25240 Erzurum, TurkeyDepartment of Obstetrics and Gynecology, Faculty of Health Sciences, Erzurum Regional Training and Research Hospital, 25240 Erzurum, TurkeyDepartment of Obstetrics and Gynecology, Ataturk University School of Medicine, 25240 Erzurum, TurkeyBackground: The objective of this study was to conduct a randomized controlled trial in order to examine the hemodynamic impacts of two different doses of intrathecal isobaric bupivacaine (5 mg and 7 mg) when combined with 15 µg fentanyl in the context of patients undergoing caesarean section under combined spinal epidural anesthesia. Methods: Eighty patients with American Society of Anesthesiologists physical status I and II, aged between 16–50 years, who would undergo elective caesarean section under combined spinal epidural anaesthesia were randomly allocated to Group A and Group B (n = 40, for each group). Group A patients received a solution containing 5 mg isobaric bupivacaine + 15 µg fentanyl (1.3 mL), while Group B patients received a solution containing 7 mg isobaric bupivacaine + 15 µg fentanyl (1.7 mL) intrathecally. Incidences of hypotension, intraoperative systolic blood pressure, diastolic blood pressure, heart rate, motor block resolving time, and analgesia duration were recorded. Results: Group A had a substantially lower incidence of hypotension than Group B (p = 0.022). Patients in Group B had significantly lower systolic blood pressure values at the 6th, 8th, 10th, 12th, 14th, 15th, and 30th minutes of the surgery compared to Group A (p = 0.012, p = 0.014, p = 0.005, p = 0.016, p < 0,001, p = 0.002, and p = 0.011; respectively). Both groups had similar diastolic blood pressure and heart rate values during surgery (p > 0.05). The motor block resolving time and analgesia duration were longer in Group B compared to Group A (p < 0.001 for both). Two (5%) patients in Group A and ten (25%) patients in Group B experienced postoperative itching (p = 0.012). Conclusions: We concluded that combining 5 mg isobaric bupivacaine with 15 mcg of fentanyl administered intrathecally provides adequate anaesthesia while maintaining better hemodynamic stability in patients undergoing caesarean section. Clinical Trial Registration: The study has been registered with registration number NCT05136040 on https://classic.clinicaltrials.gov/ct2/results?cond=&term=+NCT05136040&cntry=&state=&city=&dist=.https://www.imrpress.com/journal/CEOG/50/11/10.31083/j.ceog5011241caesarean sectionhemodynamicslow dose bupivacainespinal anaesthesia
spellingShingle Aysenur Dostbil
Canan Atalay
Ilker Ince
Mehmet Aksoy
Ozgur Ozmen
Kamber Kasali
Omer Erkan Yapca
Tugberk Kucun
Ayse Nur Aksoy
Gamze Nur Cimilli Senocak
Comparison of the Effects of Two Different Low-Doses of Isobaric Bupivacaine on Intraoperative Hemodynamics under Spinal Anaesthesia during Caesarean Section: A Randomized Controlled Trial
Clinical and Experimental Obstetrics & Gynecology
caesarean section
hemodynamics
low dose bupivacaine
spinal anaesthesia
title Comparison of the Effects of Two Different Low-Doses of Isobaric Bupivacaine on Intraoperative Hemodynamics under Spinal Anaesthesia during Caesarean Section: A Randomized Controlled Trial
title_full Comparison of the Effects of Two Different Low-Doses of Isobaric Bupivacaine on Intraoperative Hemodynamics under Spinal Anaesthesia during Caesarean Section: A Randomized Controlled Trial
title_fullStr Comparison of the Effects of Two Different Low-Doses of Isobaric Bupivacaine on Intraoperative Hemodynamics under Spinal Anaesthesia during Caesarean Section: A Randomized Controlled Trial
title_full_unstemmed Comparison of the Effects of Two Different Low-Doses of Isobaric Bupivacaine on Intraoperative Hemodynamics under Spinal Anaesthesia during Caesarean Section: A Randomized Controlled Trial
title_short Comparison of the Effects of Two Different Low-Doses of Isobaric Bupivacaine on Intraoperative Hemodynamics under Spinal Anaesthesia during Caesarean Section: A Randomized Controlled Trial
title_sort comparison of the effects of two different low doses of isobaric bupivacaine on intraoperative hemodynamics under spinal anaesthesia during caesarean section a randomized controlled trial
topic caesarean section
hemodynamics
low dose bupivacaine
spinal anaesthesia
url https://www.imrpress.com/journal/CEOG/50/11/10.31083/j.ceog5011241
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