Key result
Low-dose bupivacaine with intrathecal fentanyl cuts hypotension ~57% versus conventional bupivacaine alone.
Why the study?
Hypotension during spinal anesthesia is the most common complication causing maternal and neonatal morbidity and mortality, and low dose bupivacaine with intrathecal fentanyl is recommended to prevent it.
Does low dose bupivacaine with intrathecal fentanyl reduce the incidence of hypotension in mothers undergoing cesarean section?
Meta-Analysis (n=552)
Does low dose bupivacaine with intrathecal fentanyl reduce the incidence of hypotension in mothers undergoing cesarean section?
Relative Risk: 0.43 (95% CI 0.12–0.47)
Low dose bupivacaine combined with intrathecal fentanyl significantly decreases the incidence of hypotension during spinal anesthesia for cesarean section compared to conventional dose bupivacaine.
Supports low-dose bupivacaine plus fentanyl to reduce hypotension in cesarean spinal anesthesia; confirms and strengthens RCT evidence for routine use.
Hypotension during spinal Anesthesia is the most common complication with maternal and neonatal morbidity and mortality. Low dose bupivacaine with intrathecal fentanyl is recommended as strategy to prevent spinal Anesthesia induced hypotension and related complications. The aim of this systemic review is to evaluate the efficacy of low dose bupivacaine with Intrathecal fentanyl on the improvement of maternal and neonatal outcomes compared to conventional dose bupivacaine among mothers who undergone cesarean section. We conducted a systemic search of the electronic databases of Pubmed, Medline, LILACS and others with PICO strategy for randomized controlled clinical trials comparing low dose bupivacaine with fentanyl and conventional dose bupivacaine for cesarean section. Joanna Briggs Institute (JBI) standardized data extraction form was used for data extraction and finally entered into Review Manager for data synthesis. Ten Randomized trials (552) were included in this review. Incidence of hypotension was less likely in mothers who received low dose bupivacaine with Fentanyl as compared to those with conventional dose of bupivacaine alone (RR = 0.43, 95% confidence interval (CI) 0.12-0.47, ten trials, 552 participants). The review revealed that Low dose bupivacaine combined with intrathecal Fentanyl decrease incidence of hypotension.
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Abate et al. (2019) conducted a meta-analysis in Cesarean section (n=552). Low dose bupivacaine with intrathecal fentanyl vs. Conventional dose bupivacaine was evaluated on Incidence of hypotension (RR 0.43, 95% CI 0.12-0.47). Low dose bupivacaine with intrathecal fentanyl decreased the incidence of hypotension compared to conventional dose bupivacaine alone (RR 0.43; 95% CI 0.12-0.47).
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