دورية أكاديمية
أعرض في EDS

Comparative dose-response study of hyperbaric ropivacaine for spinal anesthesia for cesarean delivery in singleton versus twin pregnancies.

التفاصيل البيبلوغرافية
العنوان: Comparative dose-response study of hyperbaric ropivacaine for spinal anesthesia for cesarean delivery in singleton versus twin pregnancies.
المؤلفون: Mei Z; Department of Anesthesiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Anesthesiology, Zhejiang Xiaoshan Hospital, Hangzhou, China., Ngan Kee WD; Department of Anesthesiology, Sidra Medicine, Doha, Qatar., Sheng ZM; Department of Anesthesiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China., Hu LJ; Department of Anesthesiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China., Wu ZH; Department of Anesthesiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China., Lyu CC; Department of Anesthesiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China., Chen XZ; Department of Anesthesiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China., Qian XW; Department of Anesthesiology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China. Electronic address: qianxw@zju.edu.cn.
المصدر: Journal of clinical anesthesia [J Clin Anesth] 2020 Dec; Vol. 67, pp. 110068. Date of Electronic Publication: 2020 Sep 24.
نوع المنشور: Journal Article; Randomized Controlled Trial
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 8812166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4529 (Electronic) Linking ISSN: 09528180 NLM ISO Abbreviation: J Clin Anesth Subsets: MEDLINE
أسماء مطبوعة: Publication: <2008->: New York : Elsevier
Original Publication: [Stoneham, MA] : Butterworths, [c1988-
مواضيع طبية MeSH: Anesthesia, Obstetrical*/adverse effects , Anesthesia, Spinal*/adverse effects, Amides/adverse effects ; Anesthetics, Local ; Bupivacaine ; Double-Blind Method ; Female ; Humans ; Infant, Newborn ; Injections, Spinal ; Pregnancy ; Pregnancy, Twin ; Prospective Studies ; Ropivacaine
مستخلص: Study Objective: It is controversial whether local anesthetic dose requirement for spinal anesthesia for cesarean delivery differs between patients with singleton and patients with multiple gestation pregnancies. The aim of this study was to determine and compare the ED 50 and ED 90 for hyperbaric ropivacaine used for spinal anesthesia for cesarean delivery in patients with singleton pregnancies versus patients with twin pregnancies.
Design: Prospective, randomized, comparative dose-finding study.
Setting: Operating room, Women's Hospital, Zhejiang University School of Medicine.
Patients: 100 patients with singleton pregnancies (Group S) and 100 patients with twin pregnancies (Group T) presenting for scheduled cesarean delivery under combined spinal-epidural anesthesia were enrolled in the study.
Interventions: Patients in Group S or Group T were randomly allocated to receive 9.5, 11, 12.5, 14 or 15.5 mg of hyperbaric ropivacaine intrathecally. A dose was considered effective when it achieved a bilateral sensory block level at the T6 dermatome or above within 10 min after intrathecal injection, there was no numerical rating scale (NRS) pain score ≥ 3 intraoperatively, and there was no requirement for epidural supplementation at any time during anesthesia and operation. Values for ED 50 and ED 90 for ropivacaine were determined using probit regression. The difference in ropivacaine dose requirement between patients with singleton pregnancies and patients with twin pregnancies was assessed by calculating relative median potency.
Measurements: Success rates for different intrathecal doses of ropivacaine, side effects and neonatal outcomes were recorded.
Main Results: The estimated (95% confidence interval) values for ED 50 and ED 90 of intrathecal ropivacaine in patients with singleton pregnancies were 11.2 (10.2 to 12.0) mg and 15.7 (14.4 to 18.3) mg, respectively. The values for ED 50 and ED 90 in patients with twin pregnancies were 10.5 (9.5 to 11.3) mg and 14.8 mg (13.6 to 17.0) mg, respectively. The estimate of relative median potency for ropivacaine between patients with singleton and twin pregnancies was 0.94 (95% confidence interval 0.83 to 1.04).
Conclusion: Patients with singleton and twin pregnancies have similar dose requirement for hyperbaric ropivacaine used for spinal anesthesia for cesarean delivery in the setting of combined spinal-epidural (CSE) anesthesia, no opioids, low weight cohort, insertion with the patients in the right lateral position, and norepinephrine boluses.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Cesarean delivery; Ropivacaine; Singleton pregnancies; Spinal anesthesia; Twin pregnancies
المشرفين على المادة: 0 (Amides)
0 (Anesthetics, Local)
7IO5LYA57N (Ropivacaine)
Y8335394RO (Bupivacaine)
تواريخ الأحداث: Date Created: 20200927 Date Completed: 20210621 Latest Revision: 20210621
رمز التحديث: 20221213
DOI: 10.1016/j.jclinane.2020.110068
PMID: 32980764
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-4529
DOI:10.1016/j.jclinane.2020.110068