Does the Addition of Epinephrine Increase the Duration of Intrathecal Hyperbaric Bupivacaine for Repeat Cesarean Section?
Description:
Spinal anesthesia with bupivacaine is a commonly used anesthetic in the obstetric population.
It is most frequently carried out as a single shot intrathecal injection. This method can be
utilized for both labor analgesia and surgical anesthesia for cesarean section. One of the
concerns in using a single shot spinal injection for surgical anesthesia is the duration of
adequate surgical conditions. This concern is especially relevant to repeat cesarean
sections, as each subsequent procedure has the potential to be more complex than the prior
and, therefore, prolonged. A reliable way to prolong surgical anesthesia provided by single
shot spinal injection of bupivacaine could prove invaluable in the setting of repeat cesarean
section. It has been well documented that adding epinephrine to intrathecal lidocaine will
increase its duration1, but the evidence for augmenting the duration of anesthesia provided
by adding epinephrine to bupivacaine is much more equivocal and less robust. This is a
randomized control trial investigating whether or not adding epinephrine to a standard single
intrathecal injection of hyperbaric bupivacaine for repeat cesarean will prolong its
duration. It will be investigated using women who are undergoing scheduled repeat cesarean
section in whom neuraxial anesthesia is the appropriate primary anesthetic. The investigators
will compare the onset, quality and duration of both sensory and motor components of the
spinal block as well as the incidence of known side effects.
Condition:
Spinal Anesthesia
Treatment:
Low-dose epinephrine
Start Date:
February 2015
Sponsor:
Icahn School of Medicine at Mount Sinai
For More Information:
https://clinicaltrials.gov/show/NCT02369510