Key result
Hyperbaric bupivacaine resulted in a similar incidence of hypotension compared to isobaric bupivacaine (26.6% vs 23.3%) but caused a significantly greater decrease in LF/HF ratios and increase in HF values.
Why the study?
Does hyperbaric bupivacaine compared to isobaric bupivacaine alter hemodynamics and heart rate variability in patients undergoing nonobstetric surgery?
RCT (n=60)
Closed envelopes
No
Does hyperbaric bupivacaine compared to isobaric bupivacaine alter hemodynamics and heart rate variability in patients undergoing nonobstetric surgery?
Hyperbaric bupivacaine spinal anesthesia causes a greater decrease in sympathovagal balance (LF/HF ratio) and increase in parasympathetic activity (HF) compared to isobaric bupivacaine, though hemodynamic effects are similar.
Comparable hypotension supports clinical equivalence; extends evidence on baricity-specific autonomic effects in spinal anesthesia.
AIM: To compare the effects of hyperbaric and isobaric bupivacaine spinal anesthesia on hemodynamics and heart rate variability (HRV) in nonobstetric surgery. MATERIALS AND METHODS: Sixty patients were randomly allocated to 2 groups. Group I (n = 30) received 15 mg (3 mL) of hyperbaric bupivacaine and Group II (n = 30) received 15 mg (3 mL) of isobaric bupivacaine for spinal anesthesia. Hemodynamic parameters were recorded before and after spinal anesthesia over 30 min. Analyses of HRV were performed on the day of surgery, after volume loading, and 20 min after spinal injection. Low frequency (LF) values, high frequency (HF) values, and LF/HF ratios were recorded. The incidences of hypotension and alterations of HRV parameters in both groups were investigated. RESULTS: The incidence ofhypotension was 26.6% and 23.3% in Groups I and II, respectively. There were no significant differences in the LF and HF values and LF/HF ratios between groups. In Group I, LF/HF ratios were significantly lower and HF values were significantly higher at 20 min after spinal anesthesia, in comparison to the baseline value (P < 0.05). CONCLUSION: Hyperbaric bupivacaine caused a significantly greater decrease in LF/HF ratios and a significantly greater increase in HF values.
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Toptaş et al. (2014) conducted an RCT in Nonobstetric surgery requiring spinal anesthesia (n=60). Hyperbaric bupivacaine vs. 15 mg (3 mL) of 0.5% isobaric bupivacaine was evaluated on Incidence of hypotension (p=>0.05). Hyperbaric bupivacaine resulted in a similar incidence of hypotension compared to isobaric bupivacaine (26.6% vs 23.3%) but caused a significantly greater decrease in LF/HF ratios and increase in HF values.
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