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Cirugía y cirujanos
versión On-line ISSN 2444-054Xversión impresa ISSN 0009-7411
Resumen
DIAZ-PEREZ, Nelly et al. Epidural anesthesia for cesarean section with 0.125% versus 0.25% bupivacaine: An Ecuadorian prospective cohort. Cir. cir. [online]. 2021, vol.89, n.4, pp.476-483. Epub 03-Nov-2021. ISSN 2444-054X. https://doi.org/10.24875/ciru.20000567.
Background:
In a cesarean section, epidural analgesia with 0.125% bupivacaine and 1.5% lidocaine or 0.25% bupivacaine with 1.0% lidocaine concentrations can be used. A higher concentration of bupivacaine reaches better analgesia but with a higher rate of drug-related adverse events.
Aim:
The aim of the study was to assess analgesia and safety of 0.125% bupivacaine and 1.5% lidocaine or 0.25% bupivacaine with 1.0% lidocaine during cesarean.
Materials and methods:
Prospective cohort stratified following both bupivacaine concentrations.
Results:
One hundred women with full-term pregnancies were selected (fifty per cohort). At 20 and 30 min after epidural administration, there was a higher proportion of motor blockade cases from the 0.125% bupivacaine and 1.5% lidocaine cohort (p = 0.0229 and p = 0.0006, respectively). There was no significant difference among sensitive blockage. A 0.25% bupivacaine and 1.0% lidocaine concentration showed a tendency to hypotension (p < 0.001) and bradycardia (p = 0.4100). From 0.125% bupivacaine and 1.5% lidocaine cohort, 25 cases (50%) presented at least one adverse event; in contrast with 44/50 (88%) from 0.25% bupivacaine and 1.0% lidocaine cohort (p < 0.001).
Conclusion:
In epidural analgesia during cesarean, using 0.125% bupivacaine and 1.5% lidocaine presented similar analgesia than 0.25% bupivacaine and 1.0% lidocaine. However, a higher bupivacaine concentration is significantly related to more frequent drug-related adverse events (especially hypotension).
Palabras llave : Bupivacaine; Cesarean section; Drug-related side effects and adverse Reactions; Hypotension.