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Anesthesia for cesarean section requires special importance because it may affect both mother and the baby. To avoid maternal hypotension related to spinal anesthesia must be the primary objective during anesthesia. Even though many factors influence sensory nerve block for surgical anesthesia, local anesthetic dose is the main determinant. Another factor that influence the sensory nerve block is the obesity related to pregnancy. Due to the enlargement of epidural venous plexus related to pregnancy, the subarachnoid and epidural space reduces, so the local anesthetic requirement also reduces. Many investigators recommend lower dose of local anesthetic in obese patients due to reduced requirement There are many studies about dose regimens for cesarean anesthesia, but ideal dose have not been found. Investigators have designed this study to see the effects of conventional dose (10 mg bupivacaine) vs. low dose plus fentanyl (7,5 mg bupivacaine+25 mcg fentanyl) in obese and normal weight pregnant for cesarean section. The hypothesis was: the low dose regimen provides surgical anesthesia in obese patients while avoiding maternal hypotension.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I | Pregnant with BMI<30 and having spinal anesthesia with 10 mg hyperbaric bupivacaine |
| |
| Group II | Pregnant with BMI<30 and having spinal anesthesia with 7,5 mg hyperbaric bupivacaine+25 mcg fentanyl |
| |
| Group III | Pregnant with BMI>30 and having spinal anesthesia with 10 mg hyperbaric bupivacaine |
| |
| Group IV | Pregnant with BMI>30 and having spinal anesthesia with 7,5 mg hyperbaric bupivacaine+25 mcg fentanyl |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bupivacaine | Drug | To compare low dose spinal anesthesia with bupivacaine alone if it can maintain surgical anesthesia during cesarean section in obese and non-obese pregnants |
|
| Measure | Description | Time Frame |
|---|---|---|
| VAS score < 6 with only spinal anesthesia | Achieving surgical anesthesia with low dose spinal anesthesia in obese pregnants | Approximately 30 min, during surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Maternal hypotension | Avoiding maternal hypotension | Approximately 30 min, during surgery |
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Inclusion Criteria:
Exclusion Criteria:
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Patients undergoing cesarean section under spinal anesthesia in obstetric clinic
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| Name | Affiliation | Role |
|---|---|---|
| CIGDEM YILDIRIM GUCLU, MD | Ankara University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cigdem Yildirim Guclu | Ankara | 06550 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| D005283 | Fentanyl |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
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|
| Fentanyl | Drug | To compare low dose spinal anesthesia with bupivacaine+ fentanyl alone if it can maintain surgical anesthesia during cesarean section in obese and non-obese pregnants |
|
|
| D000588 |
| Amines |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |