Bicarbonato de sodio 8,4% vs fentanilo para disminuir la latencia del bloqueo epidural con bupivacaína 0.5% en cesáreas. Hospital Vicente Corral Moscoso. 2014 - 2015

Abstract

Introduction: Epidural anesthesia is a widely used technique because of its favorable operating conditions, mild respiratory depressionand gives a calmer postoperative recovery. As main disadvantage long latency time, for which the use of additives or alkalinization is recommended. Objetive: To determine the efficacy of sodium bicarbonate 8.4% vs fentanyl to decrease latency Epidural Block with Bupivacaine 0.5% in caesarean sections Materials and methods: Clinical single-blind randomized controlled trial. We randomly selected 180 patients, pregnant women, between 18 to 45 years, ASA II - III, without contraindications to epidural anesthesia for emergency cesarean section. Group A (Bupivacaine), Group B (bupivacaine / fentanyl) and Group C (Bupivacaine / Sodium Bicarbonate): Three groups were studied. Latency, sensory block, motor, and adverse hemodynamic changes were studied. Results: There were statistically significant p = 0.000 latency differences. Thus, latency for group A (Bupivacaine), average 20.42 minutes (SD: 1.29), group B (bupivacaine / fentanyl) 15.08 minutes (SD: 0.89) and group C (Bupivacaine / Sodium Bicarbonate) 8.68 minutes (DS: 0.83). Statistically significant differences in mean arterial pressure and heart rate, at 15, 30, 45 and 60 minutes but that did not compromise the life of the mother or baby; a greater number of adverse effects on the group B 88.33%, following the 31.7% group C and group A smaller proportion 3.3% Conclusions: Bupivacaine plus sodiumbicarbonate produces a shorterlatency time and fewersideeffects