Prilocaine is a local anesthetic drug which as an intermediate duration of action shorter
than bupivacaine 0,5% that is usually used for spinal anesthesia in scheduled cesarean
section. No study has yet investigated the use of hyperbaric (HB) prilocaine 2% for
intrathecal anesthesia in cesarean section. The aim of this study is to determine the
Effective Dose (ED) 95 of hyperbaric (HB) prilocaine 2% by using the Continual Reassessment
Method (CRM)
Hyperbaric bupivacaine 0.5% associated with opioids is the local anesthetic the most commonly
used for spinal injection in cesarean section. Nevertheless, its use often results in a long
duration of motor nerve block and a haemodynamical instability. Recently developped, the
Prilocaine, with its new 2% hyperbaric formulation, seems to offer a good alternative for
hyperbaric bupivicaine. A first study has determined the ED95 of hyperbaric prilocaine 2% for
intrathecal anesthesia in scheduled cesarean delivery. As opioid adjuvants potentiate the
effect of the local anesthetics while decreasing their dose-related side effects, the aim of
this study is to determine the ED95 of hyperbaric prilocaine 2% with sufentanyl for scheduled
cesarean delivery under spinal anesthesia,by using the Continual Reassessment Method (CRM)
Over the past 15 years, cesarean delivery is most commonly performed under spinal anesthesia
using hyperbaric bupivacaine which provides an adequate sensory and motor block. Despite
effective surgical anesthesia, bupivacaine is associated with long duration motor block and
dose-dependent maternal hypotension potentially harmful for the fetus. Prilocaine with its
new 2% hyperbaric formulation (HP), developed recently, showed rapid onset of action and
faster regression of motor block compared to other local anesthetics without noteworthy
side-effects when used intrathecally. The aim of this randomized, multicenter, powered
clinical trial is to investigate whether HP may be an efficient alternative to hyperbaric
bupivacaine for scheduled caesarean delivery under spinal anesthesia, with more rapid
rehabilitation and less adverse effects. Our hypothesis is that hyperbaric prilocaine offers
shorter motor block and more rapid rehabilitation than bupivacaine.
