Abstract | BACKGROUND: METHODS: Patients who were scheduled for elective CS were randomly allocated to 2 groups. Patients and all clinical staff except for an attending anesthesiologist were blinded to the allocation. After the epidural catheter was inserted at the T11-12 or T12-L1 interspace, spinal anesthesia was performed at the L2-3 or L3-4 interspace to intrathecally administer 10 mg of 0.5% hyperbaric bupivacaine. Twenty min after spinal anesthesia, either 5 mL of 2% mepivacaine (group M) or saline (group S) was administered through an epidural catheter. Vasopressors were administered prophylactically to keep both the systolic blood pressure ≥ 80 % of the baseline value with the absolute value ≥ 90 mm Hg and the mean blood pressure ≥ 60 mm Hg. The primary endpoint was the incidence of IONV. The secondary endpoints were degree of nausea, the degree and incidence of pain, and Bromage score. RESULTS: Ninety patients were randomized, and 3 patients were excluded from the final analysis. There was no significant difference in the incidence of IONV between the groups (58% in group M and 61% in group S, respectively, P = .82). In contrast, the incidence and degree of intraoperative pain in group M were significantly lower compared to group S. In addition, the incidence of rescue epidural administration of fentanyl (18% vs 47%) or mepivacaine (2.3% vs 25%) for intraoperative pain was lower in group M compared to group S. CONCLUSIONS: Our results indicate that epidural administration of 2% mepivacaine 20 minutes after spinal anesthesia does not reduce the incidence of IONV in CS under CSEA. However, intraoperative epidural administration of 2% mepivacaine was found to improve intraoperative pain.
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Authors | Takayuki Kita, Kenta Furutani, Hiroshi Baba |
Journal | Medicine
(Medicine (Baltimore))
Vol. 101
Issue 26
Pg. e29709
(Jul 01 2022)
ISSN: 1536-5964 [Electronic] United States |
PMID | 35777058
(Publication Type: Journal Article, Randomized Controlled Trial)
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Copyright | Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. |
Chemical References |
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Topics |
- Anesthesia, Obstetrical
(methods)
- Anesthesia, Spinal
(adverse effects, methods)
- Cesarean Section
(adverse effects, methods)
- Epidural Space
- Female
- Humans
- Mepivacaine
- Nausea
(etiology, prevention & control)
- Pain
- Pregnancy
- Prospective Studies
- Vomiting
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