ED50 and ED95 of Intrathecal Bupivacaine Coadministered with Sufentanil for Cesarean Delivery Under Combined Spinal-epidural in Severely Preeclamptic Patients  

作　　者：Fei Xiao Wen-Ping Xu Xiao-Min Zhang Yin-Fa Zhang Li-Zhong Wang Xin-Zhong Chen 

机构地区：[1]Department of Anesthesia, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China [2]Department of Anesthesia, Jiaxing Maternity and Child Care Hospital, Jiaxlng, Zhejiang 314005, China

出　　处：《Chinese Medical Journal》2015年第3期285-290,共6页中华医学杂志（英文版）

基　　金：This study was supported partly by the fund from National Natural Science Foundation of China （NSFC, No. 81271237 and No. 81471126） and the fund from Jiaxing Science and Technol- ogy Bureau in Zhejiang Province, China （No. 2013AY21050-2）.ACKNOWLEDGMENTS The authors would like to thank all staffs in the Department of Anesthesia and Operating Room of Jiaxing Maternity and Child Care Hospital for their help in this study.

摘　　要：Background： Spinal anesthesia was considered as a reasonable anesthetic option in severe preeclampsia when cesarean delivery is indicated, and there is no indwelling epidural catheter or contraindication to spinal anesthesia. However, the ideal dose of intrathecal bupivacaine has not been quantified for cesarean delivery for severe preeclamptic patients. This study aimed to determine the ED50 and ED95 of intrathecal bupivacaine for severely preeclamptic patients undergoing elective cesarean delivery. Methods： Two hundred severely preeclamptic patients are undergoing elective cesarean delivery under combined spinal-epidural anesthesia enrolled in this randomized, double-blinded, dose-ranging study. Patients received 4 rag, 6 mg, 8 mg, or 10 mg intrathecal hyperbaric bupivacaine with 2.5 μg sufentanil. Successful spinal anesthesia was defined as a T6 sensory level achieved within 10 minutes after intrathecal drug administration and/or no epidural supplement was required during the cesarean section. The ED50 and ED95 were calculated with a logistic regression model. Results： ED90 and ED95 ofintrathecal bupivacaine for successful spinal anesthesia were 5.67 mg （95% confidence interval [C/]： 5.20-6.10 mg） and 8.82 mg （95% CI： 8.14-9.87 mg） respectively. The incidence of hypotension in Group 8 mg and Group 10 mg was higher than that in Group 4 mg and Group 6 mg （P 〈 0.05）. The sensory block was significantly different among groups 10 minutes after intrathecal injection （P 〈 0.05）. The use of lidocaine in Group 4 mg was higher than that in other groups （P 〈 0.05）. The use of phenylephrine in Group 8 mg and Group 10 mg was higher than that in the other two groups （P 〈 0.05）. The lowest systolic blood pressure before the infant delivery of Group 8 mg and Group 10 mg was lower than the other two groups （P 〈 0.05）. The satisfaction of muscle relaxation in Group 4 mg was lower than other groups （P 〈 0.05）. There was no significant difference in patients＇ satisfaction aBackground： Spinal anesthesia was considered as a reasonable anesthetic option in severe preeclampsia when cesarean delivery is indicated, and there is no indwelling epidural catheter or contraindication to spinal anesthesia. However, the ideal dose of intrathecal bupivacaine has not been quantified for cesarean delivery for severe preeclamptic patients. This study aimed to determine the ED50 and ED95 of intrathecal bupivacaine for severely preeclamptic patients undergoing elective cesarean delivery. Methods： Two hundred severely preeclamptic patients are undergoing elective cesarean delivery under combined spinal-epidural anesthesia enrolled in this randomized, double-blinded, dose-ranging study. Patients received 4 rag, 6 mg, 8 mg, or 10 mg intrathecal hyperbaric bupivacaine with 2.5 μg sufentanil. Successful spinal anesthesia was defined as a T6 sensory level achieved within 10 minutes after intrathecal drug administration and/or no epidural supplement was required during the cesarean section. The ED50 and ED95 were calculated with a logistic regression model. Results： ED90 and ED95 ofintrathecal bupivacaine for successful spinal anesthesia were 5.67 mg （95% confidence interval [C/]： 5.20-6.10 mg） and 8.82 mg （95% CI： 8.14-9.87 mg） respectively. The incidence of hypotension in Group 8 mg and Group 10 mg was higher than that in Group 4 mg and Group 6 mg （P 〈 0.05）. The sensory block was significantly different among groups 10 minutes after intrathecal injection （P 〈 0.05）. The use of lidocaine in Group 4 mg was higher than that in other groups （P 〈 0.05）. The use of phenylephrine in Group 8 mg and Group 10 mg was higher than that in the other two groups （P 〈 0.05）. The lowest systolic blood pressure before the infant delivery of Group 8 mg and Group 10 mg was lower than the other two groups （P 〈 0.05）. The satisfaction of muscle relaxation in Group 4 mg was lower than other groups （P 〈 0.05）. There was no significant difference in patients＇ satisfaction a

关 键 词：BUPIVACAINE Cesarean Section DOSE-RESPONSE Severe Preeclampsia SPINAL 

分 类 号：S482.55[农业科学—农药学] S858.23[农业科学—植物保护]