THERAPEUTICAL NOTES   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2003 December;162(6):161-3

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: Italian

Subarachnoid levobupivacain with or without sufentanil for elective cesarean section

Borselli R., Pasqua P., Carenzi B.

Dipartimento d’Emergenza, S. C. Anestesia Rianimazione e Terapia del Dolore, Azienda Ospedaliera, Cosenza

Aim. The purpose of the study is to evaluate the efficacy and safety of “plain” 0.5% levobupivacain (chirocaine) vs levobupivacain plus sufentanil in subarachnoid block (SAB) for elective cesarean section.
Methods. We studied 30 SAB patients submitted to “plain” levobupivacain (Group 1), and 30 SAB patients, using “plain” 0.5 levobupivacain plus sufentanil (Group 2).
Results. In Group 1 the onset of the levobupivacain alone was 10-15 minutes; 7/30 patients showed mild hypotension (fall in mean arterial pressure - MAP<10%), 2/30 became more hypotensive, (20% fall in MAP) requiring drug and fluids correction, 1/30 became bradycardiac, requiring atropine, 3/30 received incremental post-operative analgesia. Group 2 (levobupivacain plus sufentanil), the anesthetic onset time was shorter: 4-7 minutes, but 12/30 patients became mildly hypotensive, 4/30 were more hypotensive after the SAB (20% fall off MAP starting values) and required drug and fluids correction. None required postoperative supplemental analgesia.
Conclusion. Levobupivacain 0.5% alone showed a longer onset time, but better cardiovascular stability; the local anesthetic-opioid mixture has a shorter onset time, an increasing number of side-effects, but better postoperative analgesia.