Authors: Ilkben Gunusen Semra Karaman Asuman Sargin Vicdan Firat
Publish Date: 2011/02/05
Volume: 25, Issue: 2, Pages: 205-212
Abstract
Levobupivacaine may produce a sensory and motor block different from that produced by bupivacaine which is the most popular local anesthetic in parturients undergoing cesarean section The aim of this study was to investigate the block characteristics the clinical efficacy surgeon and patient satisfaction and hemodynamic effects of using different doses of intrathecal plain levobupivacaine combined with fentanylOne hundred twenty women undergoing elective cesarean section with a combined spinal–epidural technique were enrolled The parturients were randomly assigned to receive one of the following levobupivacaine 5 mg group 5 75 mg group 75 or 10 mg group 10 all combined with fentanyl 25 15 or 10 μg respectivelyAnesthesia was effective in 60 825 and 100 of the patients in the levobupivacaine 5 75 and 10 mg groups respectively Levobupivacaine 10 mg provided longer durations of analgesia and motor block and greater patient and surgeon satisfaction although the incidence of hypotension was lower in groups 5 and 75 than in group 10 125 175 and 425 respectively Intraoperative epidural supplementation was higher in group 5 than in group 75 40 and 175 respectively whereas no patients in group 10 were given an epidural bolus doseThe incidence of hypotension was higher in the levobupivacaine 10 mg group even though this group presented more effective anesthesia and greater patient and surgeon satisfaction compared with the levobupivacaine 5 and 75 mg groups As a result we believe that levobupivacaine 75 mg combined with fentanyl 15 μg is suitable for combined spinal–epidural anesthesia in elective cesarean section
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