Comparison of intrathecal low-dose levobupivacaine with levobupivacaine-fentanyl and levobupivacaine-sufentanil combinations for cesarean section

WOS: 000488219400010Objectives: To compare the effectiveness and side effects of intrathecal low-dose levobupivacaine with levobupivacaine plus fentanyl or sufentanil in cesarean section Design: Prospective study Setting: Training and Research Hospital, Ankara, Turkey Subjects: A total of 45 pregnant women were enrolled to study. Interventions: Using combined spinal epidural technique, 2 ml of 0.5% levobupivacaine was added to 1 ml of saline in group I, 1 ml of 15 mu cg of fentanyl in group II and 1 ml of 1.5 mu cg sufentanil in group III by intrathecal administration. Main outcome measures: Hemodynamic parameters, sensory and motor blockade levels, intraoperative and postoperative visual analogue scale (VAS) pain scores, the time to the first analgesic requirement and adverse effects were recorded. Results: The sensory block levels were lower in group I when compared to groups II and III (p < 0.05). Intraoperative and postoperative VAS scores were higher in group I than groups II and III (p < 0.05). The time to first analgesic requirement in the postoperative period (VAS = 3) and the time to the application of first analgesic dose by epidural catheter was significantly shorter in group I than in groups II and III (p < 0.05). Nausea (n: 0,9,8), vomiting (n: 0,2,0), bradycardia (n: 0,1,2), and hypotension (n: 5,10,9) were the adverse effects found in groups I, II and III respectively. Conclusion: Intrathecal levobupivacaine 10 mg in 3 ml solution does not provide adequate anesthesia during elective cesarean section. We found that the major adverse effect of adding fentanyl or sufentanil to levobupivacaine is the increase in nausea