The effects of isobaric and hyperbaric bupivacaine on maternal hemodynamic changes after spinal anesthesia for elective cesarean section.

dc.contributor.advisorAdmasu, Wossenyeleh (Msc, Lecturer)
dc.contributor.authorEanga, Shamil
dc.date.accessioned2018-11-30T07:24:55Z
dc.date.accessioned2023-11-05T09:40:05Z
dc.date.available2018-11-30T07:24:55Z
dc.date.available2023-11-05T09:40:05Z
dc.date.issued2018-06
dc.description.abstractBackground: The most common local anesthetic used for spinal anesthesia in obstetric and nonobstetric surgery is bupivacaine that can be used as isobaric or hyperbaric solutions. Cesarean section is usually performed under spinal anesthesia using hyperbaric bupivacaine which is associated with an increased incidence of severe hypotension. Isobar bupivacaine is not commonly used but it could be a good alternative due to having lower maternal hemodynamic changes than hyperbaric bupivacaine. Objective: To compare the effects of isobaric and hyperbaric bupivacaine on maternal hemodynamic changes after spinal anesthesia for elective cesarean section at Gandhi memorial hospital, Addis Ababa, Ethiopia from December 1 2017 to January 30, 2018. Methods: Hospital based prospective cohort study design was employed on a total of 100 parturients with a group exposed to isobaric received 12.5 mg of isobaric bupivacaine and unexposed to hyperbaric group received 12.5 mg of hyperbaric bupivacaine to see the effect on maternal hemodynamic changes after spinal anesthesia. Study participants were selected by using systematic random sampling. Symmetric data was analyzed by using independent t-test and asymmetric data by Mann-Whitney U-test and homogenous categorical data by using chisquare test. The level of statistical significance for all tests was P < 0.05. Results: The incidence of hypotension was higher in isobaric than hyperbaric groups (82% vs. 60% respectively; p = 0.015). There was no statistical significant differences in mean arterial pressure value at baseline, but after spinal anesthesia statistically significant changes were observed among the groups (p < 0.05) at all study timing, but at 30th min. There was no statistical significant differences in the mean heart rate variability after spinal anesthesia at all periods, except at 15th minute (p = 0.033). Higher rate of vasopressor was used in isobaric than hyperbaric groups (36% vs. 14% respectively; p = 0.011). Conclusion: Baricity is a significant factor for the maternal hemodynamic changes in parturiants for elective cesarean section. Isobaric bupivacaine produces higher change in blood pressure and incidence of hypotension, increase vasopressor requirement than hyperbaric bupivacaine after spinal anesthesia for elective cesarean section.en_US
dc.identifier.urihttp://etd.aau.edu.et/handle/123456789/14732
dc.language.isoen_USen_US
dc.publisherAddis Ababa Universtyen_US
dc.subjectisobaric bupivacaine, hyperbaric bupivacaine, maternal hemodynamic changes, elective cesarean section.en_US
dc.titleThe effects of isobaric and hyperbaric bupivacaine on maternal hemodynamic changes after spinal anesthesia for elective cesarean section.en_US
dc.typeThesisen_US

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