This study evaluates the effect of subarachnoid hyperbaric bupivacaine on mean arterial blood
pressure (MAP) of pregnant patients with obesity undergoing cesarean section half of the
patients will receive subarachnoid hyperbaric bupivacaine at a dose of 5 mg while the other
half will receive a dose of 10 mg
Anesthesia
Clinical Trial – Use of Intrathecal Analgesia in Appendectomy
Acute appendicitis which is the most common cause of acute abdominal pain, is an acute
inflammation of appendix vermiformis. Appendectomy operations can be performed as
laparoscopic and open surgery. Addition of opioids to intrathecal local anesthetics to
improve the quality of preoperative analgesia is an increasingly used method in recent years.
The aim of this study is to compare bupivacaine-fentanyl and bupivacaine-alfentanil which are
used intrathecally to create motor and sensory block. 50 volunteer patients who were
diagnosed as appendicitis by laboratory tests and clinical diagnostic methods in general
surgery clinic and classified as American Society of Anesthesiologists Classification I-II
(ASA Class I-II) aged between 20-60 years scheduled for laparoscopic appendectomy operation,
were included in this study. The patients were randomly assigned into two groups, Group I and
Group II. Patients received spinal anesthesia with either 10 mg heavy bupivacaine (2 cc)+25
mcg fentanyl (0.5 cc) intrathecally (Group I, n=25) or 10 mg heavy bupivacaine (2 cc)+250 mcg
alfentanil (0.5 cc) intrathecally (Group II, n=25).
Clinical Trial – Intrathecal Additives to Prevent Post Spinal Shivering in Transurethral Prostatectomy
Spinal anesthesia is the technique of choice in transurethral prostatectomy.However,one of
the common complications of spinal anesthesia is shivering which is even exaggerated in
patients undergoing transurethral prostatectomy.this high incidence is most probably caused
by sympathetic block and use of large amount of irrigation fluid during surgery.There are two
methods to reduce shivering.Previous studies showed that intrathecal fentanyl is an
appropriate method to reduce shivering.Intrathecal dexamethasone could reduce shivering by
regulating immune responses.
Clinical Trial – Comparison of Clorotekal and Bupivacaine for Short Obstetric Surgery
The following obstetric procedures are commonly performed with spinal anesthesia on labor and
delivery: bilateral tubal ligation, external cephalic version, cerclage insertion, cerclage
removal, minimally invasive fetal surgery, and evacuation of retained products of conception.
Bupivacaine is currently the standard spinal medication for these procedures because of its
long history of safe use, its low incidence of transient neurologic symptoms, and its ability
to provide a dependable, dense block with a high degree of maternal satisfaction. While
bupivacaine has the aforementioned advantages, it unfortunately has a long duration of
action, up to 240-380 minutes, which far exceeds the time necessary to complete most
obstetric procedures. Clorotekal®, the first Food and Drug Administration approved
chloroprocaine solution created for spinal injection, is a potential alternative. When
compared with bupivacaine spinals, chloroprocaine spinals have been shown to facilitate
clinically significant shorter times to resolution of motor and sensory block, first
ambulation, micturition, and discharge readiness. The objective of this study is to determine
if a strategy of spinal anesthesia with chloroprocaine will reduce the duration of motor
block, compared with equivalent block with hyperbaric bupivacaine..
Clinical Trial – ED50 and ED95 of Isobaric Bupivacaine for Post-Partum Bilateral Tubal Ligation
Spinal anesthesia is one of the preferred anesthetic techniques for post-partum bilateral
tubal ligation (PBTL). Bupivacaine is the most commonly used local anesthetic for neuraxial
anesthesia for post-partum tubal ligation. Typically, hyperbaric bupivacaine would be
injected into the spinal (intrathecal) space via a spinal needle; however, ongoing medication
shortages have resulted in limited availability on a local and national level. One proposed
alternative is isobaric bupivacaine; however, studies investigating its use for post-partum
bilateral tubal ligation are limited.
The purpose of this prospective study is to determine the minimal effective dose (ED50 and
ED95) of isobaric bupivacaine for adequate anesthesia during post-partum tubal ligation after
vaginal delivery.
Clinical Trial – Dosing of Carcinogenic Complexes After Anesthesia With Intrathecal Hyperbaric Prilocaine.
The prilocaine is a very common local anesthetic that has the disadvantage of being
metabolized to o-toluidine, a human carcinogen.
Hyperbaric 2% prilocaine (HP), recently developped, is increasingly used for spinal
anesthesia in ambulatory surgery. But the formation of carcinogenic metabolites induced by
the hyperbaric prilocaine is not yet known. The aim of this study is to investigate whether
the intrathecal administration of 50 mg hyperbaric prilocaine induces also the formation of
carcinogenic complexes such as urinary o-toluidine and hemoglobin adducts from o-toluidine in
blood.
Clinical Trial – Spinal Marginally Hyperbaric Ropivacaine for Cesarean Delivery
BACKGROUND: One previous study has confirmed that the marginally hyperbaric solutions of
bupivacaine can maintain good quality of anesthesia and get a more steadily hemodynamic
status than commonly hyperbaric solutions, some authors confirmed the plain ropivacaine for
cesarean section have a higher failure rate and commonly hyperbaric solutions of ropivacaine
have a higher incidence of side reaction. It is unclear what the efficacy of spinal
marginally hyperbaric ropivacaine for elective cesarean delivery.We hypothesized that the
marginally hyperbaric ropivacaine will get a similar efficacy to commonly hyperbaric
solutions but a more steadily hemodynamic status.
OBJECTIVE In this prospective, randomized, double-blinded study, Investigator will compare
the clinical efficacy and adverse effect of spinal anesthesia with commonly hyperbaric and
marginally hyperbaric ropivacaine for elective cesarean delivery.
Main outcome measures: The maximum cephalad sensory block level; the change of continuous
cerebral oxygen desaturation (ScO2) over time; the incidence of hypotension and nausea and
vomiting; the change of invasive arterial pressure; the consumption of ephedrine; the
incidence of shivering; the onset time to T8 dermatome; the quality of anesthesia (efficacy
of motor block and sensory block)
Clinical Trial – Spinal Anesthesia for Outpatient Abdominal Wall Surgery: Comparison of Bupivacaine, 2-chloroprocaine and Prilocaine
Considering fast-track principles, an ideal spinal anesthetic should have minimal
complications and above all fast recovery so reducing in-hospital stay.
Between 1/8/2015 and 1/1/2016, a total of 101 patients attending the surgeon’s practice with
an umbilical or unilateral inguinal hernia and no contra-indications for surgery were
included in this study. Patients were given 10.5mg bupivacaine (B-group), 40mg hyperbaric
2-chloroprocaïne (C-group) or 60mg prilocaïne (P-group), each with added sufentanil (2µg).
Motor block was assessed using the Bromage scale. Sensory block was measured by determining
the peak level dermatome. Intraoperative hemodynamic parameters were listed. Resolution of
sensory and motor block, time to void and home readiness were defined as clinical endpoints.
Clinical Trial – Application of Combined Lumbar Plexus and Sciatic Nerve Block
The research is to study the effectiveness and safety of combined lumbar plexus and sciatic
nerve block by the guide of peripheral nerve stimulator (PNS) in unilateral knee
replacement.There have be some papers which supported that combined lumbar plexus and sciatic
nerve block may be more suitable for the old men.
Clinical Trial – Recovery of Bupivacaine or Bupivacaine-Lidocaine Spinal Anesthesia and Infiltration Anesthesia in Herniorrhaphy
The purpose of this study is the investigation of whether adding lidocaine to hyperbaric
bupivacaine could decrease the duration of bupivacaine spinal block and provide shorter
recovery and discharge times than local infiltration anesthesia in outpatient herniorrhaphy
procedures.