Comparative Study of Isobaric and Hyperbaric Solution of Bupivacaine for Spinal Anaesthesia in Caesarean Section

XU Li,GUO Qu-lian,YAN Jian-qin(Department of Anaesthesiology,Xiangya Hospital,Central South University,Changsha 410008,Hunan,China)  

Objective To compare the application of isobaric and hyperbaric solution of bupivacacine for spinal anesthesia in caesarean section and provide reference materials for clinical practice. Methods One hundred ASA physical status I~II full term pregnant woman planed to receive cesarean section under spinal anesthesia(using CSEA technique via spinal needle in epidural needle) were randomized to receive subarachnoid injection of 2.0ml(10mg) isobaric(group I,50 cases) or hyperbaric(group H,50 cases) bupivacaine and then turned supine.Perioperative hemodynamic parameters and patients' anesthesia responses were monitored,including the time of onset and motor block,peak sensory blocked level,the time to regression of 2 dermatomes,the time to the first administration of analgesics,the time to the regression of motor block to modified Bromage scale 2. Results Both isobaric and hyperbaric 0.5% bupivacaine solutions in a volume of 2.0 ml provided effective sensory and motor block.Time to onset and complete motor block was similar.Compared with group I,the time to peak sensory block was shorter,peak sensory block level was higher(maximal dermatomes of blocked sensory nerves were more),time to regression of sensory and motor block was shorter,the incidence of uncomfortable feeling,nausea,vomit and hypotension was higher in group H. Conclusion Spinal anesthesia with isobaric solution is superior to that with hyperbaric solution as the hemodynamic parameters are relatively stable,the lower incidence of uncomfortable feelings,the lower incidence of other adverse effects,and its longer duration of anesthesia and analgesia.

【Key Words】： Caesarean section Spinal anesthesia Isobaric Hyperbaric
【CateGory Index】： R719.8

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