Spinal anesthesia for elective ceasarean section: use of different doses of hyperbaric bupivacaine associated with morphine and clonidine

Acta Cir Bras. 2013 Jan;28(1):26-32. doi: 10.1590/s0102-86502013000100005.

Abstract

Purpose: To comparatively study the efficacy and maternal and fetal side-effects of two doses of bupivacaine associated with morphine and clonidine, administered by the subarachnoid route for cesarean section.

Methods: The study included 66 pregnant women at term, distributed into two groups. GI: bupivacaine 8.0 mg (1.6 mL) + clonidine 75 µg (0.5 mL) + morphine 100 µg (1.0 mL) and GII: bupivacaine 10 mg (2.0 mL) + clonidine 75 µg (0.5 mL) + morphine 100 µg (1.0 mL). The following parameters were assessed: onset and maximum level of sensory block; quality of intraoperative and postoperative analgesia; degree and duration of motor block; maternal repercussions and Apgar score.

Results: The onset of sensory block, quality of intraoperative analgesia and total duration of analgesia were similar in both groups; maximum extent of sensory block predominated in T4; maximum degree of motor block (Bromage 3); time motor block regression was significantly longer in GII; Hemodynamic, respiratory repercussions, adverse maternal effects and Apgar scores were similar between groups. In both groups, there was a predominance of drowsy or sleeping patients.

Conclusion: The addition of morphine and clonidine to low doses of hyperbaric bupivacaine produced adequate anesthesia for cesarean section and good postoperative analgesia, without any maternal and fetal repercussions.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adjuvants, Anesthesia / administration & dosage
  • Adjuvants, Anesthesia / adverse effects
  • Adrenergic alpha-2 Receptor Agonists / administration & dosage
  • Adrenergic alpha-2 Receptor Agonists / adverse effects
  • Adult
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Anesthesia, Spinal / methods*
  • Anesthetics, Combined / administration & dosage*
  • Anesthetics, Combined / adverse effects
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / adverse effects
  • Anthropometry
  • Bupivacaine / administration & dosage*
  • Bupivacaine / adverse effects
  • Cesarean Section / methods*
  • Clonidine / administration & dosage*
  • Clonidine / adverse effects
  • Elective Surgical Procedures / methods
  • Epidemiologic Methods
  • Female
  • Humans
  • Morphine / administration & dosage*
  • Morphine / adverse effects
  • Pain, Postoperative
  • Pregnancy
  • Time Factors
  • Young Adult

Substances

  • Adjuvants, Anesthesia
  • Adrenergic alpha-2 Receptor Agonists
  • Analgesics, Opioid
  • Anesthetics, Combined
  • Anesthetics, Local
  • Morphine
  • Clonidine
  • Bupivacaine