De ARA, Aguilar-González CL, Moreno-Barrón ML

Language: Spanish
References: 18
Page: 70-76
PDF size: 491.92 Kb.

ABSTRACT

Introduction: epidural bupivacaine at concentrations below 0.1% after multimodal intrathecal anesthesia (MIA) offers very good anesthetic efficacy and very good hemodynamic control due to its lower effects on the sympathetic nervous system. Objective: to evaluate the anesthetic efficacy and safety of low concentrations of epidural bupivacaine with the combined spinal-epidural technique in hysterectomies. Material and methods: a randomized, controlled, double-blind clinical trial was conducted in women scheduled for total abdominal hysterectomy (TAH). The trial was divided into 4 groups: group SB2 (isobaric bupivacaine 0.025% 5 mg), group SB5 (isobaric bupivacaine 0.05% 10 mg), group SB7 (isobaric bupivacaine 0.075% 15 mg), and group SB1 (isobaric bupivacaine 0.1% 20 mg). The anesthetic efficacy of the epidural dose was assessed based on a) whether the intrathecal dose required supplementation, b) the 60-minute period until the compresses were removed from the abdominal cavity, c) the need for a rescue dose or a second subsequent dose, and d) the immediate postoperative period, as well as vital signs. Results: a total of 168 women were analyzed, in whom anesthetic effectiveness and hemodynamic control could be considered very good, with no significant statistical differences found between groups. Conclusion: epidural concentrations of less than 0.1% bupivacaine offer very good anesthetic effectiveness and hemodynamic control.

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