alexa Low Dose Hyperbaric Bupivacaine 5 mg Combined with 50 mcg Fentanyl for Caesarean Section Delivery in Patient with Maternal Heart Disease | OMICS International| Abstract
ISSN: 2155-6148

Journal of Anesthesia & Clinical Research
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  • Research Article   
  • J Anesth Clin Res 2019, Vol 10(6): 896

Low Dose Hyperbaric Bupivacaine 5 mg Combined with 50 mcg Fentanyl for Caesarean Section Delivery in Patient with Maternal Heart Disease

Husodo DP1, Isngadi I1, Hartono R1 and Prasedya ES2,3*
1Department of Anesthesiology and Intensive Care, Faculty of Medicine, Brawijaya University, Jawa Timur 65145, Indonesia
2Bioscience and Biotechnology Research Centre, Faculty of Mathematics and Natural Sciences, University of Mataram, Nusa Tenggara Bar 83115, Indonesia
3Department of Cellular and Integrative Physiology, Fukushima Medical University, Fukushima, Japan
*Corresponding Author : Dr. Prasedya ES, Department of Cellular and Integrative Physiology, Fukushima Medical University, Fukushima, Japan, Email: [email protected]

Received Date: May 09, 2019 / Accepted Date: Jun 10, 2019 / Published Date: Jun 17, 2019

Abstract

Most of women with cardiovascular diseases show worsen clinical condition during pregnancy. That is caused by cardiovascular physiological change during pregnancy and increased demand of oxygen-metabolic system. Spinal anesthesia is the most used technique in section caesaria patient, but there’s worried about using spinal anesthesia in patient with cardiac disease due to sudden hemodynamic decrease. Recent studies have proved hemodynamic changes in spinal anesthesia is dose dependent. Dose decreased of spinal anesthesia have potency of inadequate block and change of maternal-fatal hemodynamic due to pain or uncomforted feeling. It can be prevented by using opiod adjuvant that has good effect in anesthesia block. This is retrospective study in 33 patients with maternal heart disease undergoing CS under low dose spinal anesthesia in Saiful Anwar Hospital Malang Indonesia from September 2017 until September 2018. The spinal regimen was 5 mg bupivacaine heavy 0,5% combined with 50 mcg fentanyl. We evaluated the hemodynamic preoperative, post injection of spinal anesthetics, post-delivery, at the end of surgery. We also evaluated bromage score, Apgar score of the baby, and relaxation satisfaction from obstetrician. Combination low dose spinal and opioid for the CS delivery show no significant hypotension effects. It stabilized the hemodynamic prior to injection, post injection, after delivery, post-operative as well as in the recovery room. Furthermore, target blocked was reached well in all cases, no significant changes in Apgar score of the baby, and obstetrician satisfied with motoric relaxation. Low dose spinal anesthesia using 5 mg of bupivacaine heavy 0,5% and adjuvant opioid fentanyl 50 mcg can be successfully used for the performance of CS delivery as regards to onset, adequacy, level, duration of the block and hemodynamic stability and good fetal outcome, with impressive cardiovascular stability.

Keywords: Spinal anesthesia; Cardiac abnormalities; Caesarean section

Citation: Husodo DP, Isngadi I, Hartono R, Prasedya ES (2019) Low Dose Hyperbaric Bupivacaine 5 mg Combined with 50 mcg Fentanyl for Caesarean Section Delivery in Patient with Maternal Heart Disease. J Anesth Clin Res 10: 896.

Copyright: © 2019 Husodo DP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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