Cargando…

Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial

BACKGROUND: Spinal anesthesia (SPA) is the most common type of anesthesia administered for cesarean section. The main aim of this study was to evaluate the effect of aspiration of CSF (0.2 mL) immediately after SPA with hyperbaric 0.5% bupivacaine on the extent of sensory and motor block. METHODS: I...

Descripción completa

Detalles Bibliográficos
Autores principales: Manouchehrian, Nahid, Miri, Zahra, Esna-Ashari, Farzaneh, Rahimi-Bashar, Farshid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8990041/
https://www.ncbi.nlm.nih.gov/pubmed/35402445
http://dx.doi.org/10.3389/fmed.2022.816974
_version_ 1784683301102944256
author Manouchehrian, Nahid
Miri, Zahra
Esna-Ashari, Farzaneh
Rahimi-Bashar, Farshid
author_facet Manouchehrian, Nahid
Miri, Zahra
Esna-Ashari, Farzaneh
Rahimi-Bashar, Farshid
author_sort Manouchehrian, Nahid
collection PubMed
description BACKGROUND: Spinal anesthesia (SPA) is the most common type of anesthesia administered for cesarean section. The main aim of this study was to evaluate the effect of aspiration of CSF (0.2 mL) immediately after SPA with hyperbaric 0.5% bupivacaine on the extent of sensory and motor block. METHODS: In this clinical trial, 60 women at ≥37 weeks of gestation and aged between 18 and 46 years, candidate for cesarean delivery under spinal anesthesia were randomly allocated into two equal groups (n = 30). Group A (CSF-aspiration group) received the spinal anesthesia with 10 mg of hyperbaric 0.5% bupivacaine with aspiration of 0.2 ml of CSF. Group B (no-CSF-aspiration group) received only 10 mg of 0.5% hyperbaric bupivacaine. Pin-prick analgesia and motor block were tested during the induction. RESULTS: The mean maximum level of analgesia was T6 in each group. Although the mean time to reach the maximum level of anesthesia (4.43 ± 5.14 vs. 2.76 ± 2.04, P = 0.107) and to reach T10 level (50.56 ± 11.51 vs. 49.10 ± 13.68, P = 0.665) in the CSF-aspiration group is longer than the non-CSF-aspiration group, but this differences were not significant. There were no significant between-group differences regarding sensory and motor block quality (P = 0.389) or failed SPA (four cases in CSF-aspiration group vs. two cases in no-CSF-aspiration group, P = 0.389). The incidence of bradycardia, hypotension, headache, vomiting and nausea were similar in both groups (P > 0.05). In addition, the difference in hemodynamic parameters between the two groups over times was not statistically significant. CONCLUSION: Our finding indicated that the aspiration of 0.2 ml of CSF after injection of spinal anesthesia with hyperbaric 0.5% bupivacaine does not seem to affect the extent of sensory and motor block, success rate, or outcome after SPA in cesarean section. CLINICAL TRIAL REGISTRATION: [https://www.irct.ir/search/result?query=IRCT20120915010841N25], identifier [IRCT20120915010841N25].
format Online
Article
Text
id pubmed-8990041
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-89900412022-04-09 Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial Manouchehrian, Nahid Miri, Zahra Esna-Ashari, Farzaneh Rahimi-Bashar, Farshid Front Med (Lausanne) Medicine BACKGROUND: Spinal anesthesia (SPA) is the most common type of anesthesia administered for cesarean section. The main aim of this study was to evaluate the effect of aspiration of CSF (0.2 mL) immediately after SPA with hyperbaric 0.5% bupivacaine on the extent of sensory and motor block. METHODS: In this clinical trial, 60 women at ≥37 weeks of gestation and aged between 18 and 46 years, candidate for cesarean delivery under spinal anesthesia were randomly allocated into two equal groups (n = 30). Group A (CSF-aspiration group) received the spinal anesthesia with 10 mg of hyperbaric 0.5% bupivacaine with aspiration of 0.2 ml of CSF. Group B (no-CSF-aspiration group) received only 10 mg of 0.5% hyperbaric bupivacaine. Pin-prick analgesia and motor block were tested during the induction. RESULTS: The mean maximum level of analgesia was T6 in each group. Although the mean time to reach the maximum level of anesthesia (4.43 ± 5.14 vs. 2.76 ± 2.04, P = 0.107) and to reach T10 level (50.56 ± 11.51 vs. 49.10 ± 13.68, P = 0.665) in the CSF-aspiration group is longer than the non-CSF-aspiration group, but this differences were not significant. There were no significant between-group differences regarding sensory and motor block quality (P = 0.389) or failed SPA (four cases in CSF-aspiration group vs. two cases in no-CSF-aspiration group, P = 0.389). The incidence of bradycardia, hypotension, headache, vomiting and nausea were similar in both groups (P > 0.05). In addition, the difference in hemodynamic parameters between the two groups over times was not statistically significant. CONCLUSION: Our finding indicated that the aspiration of 0.2 ml of CSF after injection of spinal anesthesia with hyperbaric 0.5% bupivacaine does not seem to affect the extent of sensory and motor block, success rate, or outcome after SPA in cesarean section. CLINICAL TRIAL REGISTRATION: [https://www.irct.ir/search/result?query=IRCT20120915010841N25], identifier [IRCT20120915010841N25]. Frontiers Media S.A. 2022-03-25 /pmc/articles/PMC8990041/ /pubmed/35402445 http://dx.doi.org/10.3389/fmed.2022.816974 Text en Copyright © 2022 Manouchehrian, Miri, Esna-Ashari and Rahimi-Bashar. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Manouchehrian, Nahid
Miri, Zahra
Esna-Ashari, Farzaneh
Rahimi-Bashar, Farshid
Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_full Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_fullStr Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_full_unstemmed Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_short Evaluation Effect of Aspiration of 0.2 ml of Cerebrospinal Fluid After Completion of Injection 0.5% Bupivacaine and Reinjection Into Subarachnoid Space on Sensory and Motor Block in Cesarean Section: A Randomized Clinical Trial
title_sort evaluation effect of aspiration of 0.2 ml of cerebrospinal fluid after completion of injection 0.5% bupivacaine and reinjection into subarachnoid space on sensory and motor block in cesarean section: a randomized clinical trial
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8990041/
https://www.ncbi.nlm.nih.gov/pubmed/35402445
http://dx.doi.org/10.3389/fmed.2022.816974
work_keys_str_mv AT manouchehriannahid evaluationeffectofaspirationof02mlofcerebrospinalfluidaftercompletionofinjection05bupivacaineandreinjectionintosubarachnoidspaceonsensoryandmotorblockincesareansectionarandomizedclinicaltrial
AT mirizahra evaluationeffectofaspirationof02mlofcerebrospinalfluidaftercompletionofinjection05bupivacaineandreinjectionintosubarachnoidspaceonsensoryandmotorblockincesareansectionarandomizedclinicaltrial
AT esnaasharifarzaneh evaluationeffectofaspirationof02mlofcerebrospinalfluidaftercompletionofinjection05bupivacaineandreinjectionintosubarachnoidspaceonsensoryandmotorblockincesareansectionarandomizedclinicaltrial
AT rahimibasharfarshid evaluationeffectofaspirationof02mlofcerebrospinalfluidaftercompletionofinjection05bupivacaineandreinjectionintosubarachnoidspaceonsensoryandmotorblockincesareansectionarandomizedclinicaltrial