Combination of Low‐Dose Bupivacaine and Opioids Provides Satisfactory Analgesia with Less Intraoperative Hypotension for Spinal Anesthesia in Cesarean Section
Identifieur interne : 000694 ( Istex/Corpus ); précédent : 000693; suivant : 000695Combination of Low‐Dose Bupivacaine and Opioids Provides Satisfactory Analgesia with Less Intraoperative Hypotension for Spinal Anesthesia in Cesarean Section
Auteurs : Man-Tang Qiu ; Fu-Qing Lin ; Shu-Kun Fu ; Heng-Bin Zhang ; Hui-Hua Li ; Li-Ming Zhang ; Quan LiSource :
- CNS Neuroscience & Therapeutics [ 1755-5930 ] ; 2012-05.
English descriptors
- KwdEn :
- Analgesia, Analgesic, Anesth, Anesth analg, Anesthesia, Baseline, Blackwell publishing, Blood pressure, Bupivacaine, Caesarean, Caesarean section, Cesarean, Cesarean delivery, Cesarean section, Eligible trials, Ephedrine, Epidural anesthesia, Fentanyl, Heterogeneity, Hypotension, Intraoperative, Intraoperative analgesia, Intraoperative hypotension, Intrathecal, Intrathecal bupivacaine, Introoperative, Introoperative analgesia, Introoperative analgesiab, Maternal hypotension, Meperidine, Neuroscience, Neuroscience therapeutics, Opioids, Original study data, Parturients, Primary endpoints, Publishing time, Regimen, Reliable analgesia, Spinal, Spinal anesthesia, Therapeutics, Total dose.
- Teeft :
- Analgesia, Analgesic, Anesth, Anesth analg, Anesthesia, Baseline, Blackwell publishing, Blood pressure, Bupivacaine, Caesarean, Caesarean section, Cesarean, Cesarean delivery, Cesarean section, Eligible trials, Ephedrine, Epidural anesthesia, Fentanyl, Heterogeneity, Hypotension, Intraoperative, Intraoperative analgesia, Intraoperative hypotension, Intrathecal, Intrathecal bupivacaine, Introoperative, Introoperative analgesia, Introoperative analgesiab, Maternal hypotension, Meperidine, Neuroscience, Neuroscience therapeutics, Opioids, Original study data, Parturients, Primary endpoints, Publishing time, Regimen, Reliable analgesia, Spinal, Spinal anesthesia, Therapeutics, Total dose.
Abstract
SUMMARY Aims: This meta‐analysis was undertaken to compare the three most common drug regimens of bupivacaine in spinal anesthesia for cesarean section: high‐dose bupivacaine (≥10 mg, HB), low‐dose bupivacaine (<10 mg, LB) and combination of low‐dose bupivacaine and opioids (LBO). Methods: Databases of MEDLINE, EMBASE, and Cochrane Library were searched (updated on October 30, 2011). Primary endpoints were the incidence of intraoperative hypotension and analgesia efficacy. Pooled risk ratio (RR) or standard mean difference and their 95% confidence intervals (95% CI) were calculated. A RR <1 indicates that LB or LBO regimen is associated with less intraoperative complications and better anesthesia or analgesia efficacy. Results: A total of 11 randomized controlled trials including 605 parturients were analyzed. Results of this meta‐analysis showed that compared with HB regimen, LB regimen decreased the incidence of intraoperative hypotension (RR = 0.64, 95% CI: 0.42–0.96) with less satisfactory analgesia (fixed model, RR = 1.50, 95% CI: 1.14–1.98). LBO regimen significantly reduced the incidence of intraoperative hypotension (RR = 0.52, 95% CI: 0.33–0.82) with reliable analgesia efficacy (RR = 2.56, 95% CI: 0.77–8.48). Conclusion: Compared with conventional HB regimen and LB regimen, LBO regimen not only reduced intraoperative hypotension but also provided reliable analgesia. Therefore, LBO regimen should be considered as the preferred drug combination for spinal anesthesia in cesarean section.
Url:
DOI: 10.1111/j.1755-5949.2012.00306.x
Links to Exploration step
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<front><div type="abstract">SUMMARY Aims: This meta‐analysis was undertaken to compare the three most common drug regimens of bupivacaine in spinal anesthesia for cesarean section: high‐dose bupivacaine (≥10 mg, HB), low‐dose bupivacaine (<10 mg, LB) and combination of low‐dose bupivacaine and opioids (LBO). Methods: Databases of MEDLINE, EMBASE, and Cochrane Library were searched (updated on October 30, 2011). Primary endpoints were the incidence of intraoperative hypotension and analgesia efficacy. Pooled risk ratio (RR) or standard mean difference and their 95% confidence intervals (95% CI) were calculated. A RR <1 indicates that LB or LBO regimen is associated with less intraoperative complications and better anesthesia or analgesia efficacy. Results: A total of 11 randomized controlled trials including 605 parturients were analyzed. Results of this meta‐analysis showed that compared with HB regimen, LB regimen decreased the incidence of intraoperative hypotension (RR = 0.64, 95% CI: 0.42–0.96) with less satisfactory analgesia (fixed model, RR = 1.50, 95% CI: 1.14–1.98). LBO regimen significantly reduced the incidence of intraoperative hypotension (RR = 0.52, 95% CI: 0.33–0.82) with reliable analgesia efficacy (RR = 2.56, 95% CI: 0.77–8.48). Conclusion: Compared with conventional HB regimen and LB regimen, LBO regimen not only reduced intraoperative hypotension but also provided reliable analgesia. Therefore, LBO regimen should be considered as the preferred drug combination for spinal anesthesia in cesarean section.</div>
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<abstract>SUMMARY Aims: This meta‐analysis was undertaken to compare the three most common drug regimens of bupivacaine in spinal anesthesia for cesarean section: high‐dose bupivacaine (≥10 mg, HB), low‐dose bupivacaine (>10 mg, LB) and combination of low‐dose bupivacaine and opioids (LBO). Methods: Databases of MEDLINE, EMBASE, and Cochrane Library were searched (updated on October 30, 2011). Primary endpoints were the incidence of intraoperative hypotension and analgesia efficacy. Pooled risk ratio (RR) or standard mean difference and their 95% confidence intervals (95% CI) were calculated. A RR >1 indicates that LB or LBO regimen is associated with less intraoperative complications and better anesthesia or analgesia efficacy. Results: A total of 11 randomized controlled trials including 605 parturients were analyzed. Results of this meta‐analysis showed that compared with HB regimen, LB regimen decreased the incidence of intraoperative hypotension (RR = 0.64, 95% CI: 0.42–0.96) with less satisfactory analgesia (fixed model, RR = 1.50, 95% CI: 1.14–1.98). LBO regimen significantly reduced the incidence of intraoperative hypotension (RR = 0.52, 95% CI: 0.33–0.82) with reliable analgesia efficacy (RR = 2.56, 95% CI: 0.77–8.48). Conclusion: Compared with conventional HB regimen and LB regimen, LBO regimen not only reduced intraoperative hypotension but also provided reliable analgesia. Therefore, LBO regimen should be considered as the preferred drug combination for spinal anesthesia in cesarean section.</abstract>
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<title level="a" type="short">A Meta‐Analysis of 11 Trials</title>
<author xml:id="author-0000"><persName><forename type="first">Man‐Tang</forename>
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<author xml:id="author-0001"><persName><forename type="first">Fu‐Qing</forename>
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<profileDesc><abstract xml:lang="en" style="main"><p><hi rend="bold">SUMMARY </hi>
<hi rend="bold">Aims:</hi>
This meta‐analysis was undertaken to compare the three most common drug regimens of bupivacaine in spinal anesthesia for cesarean section: high‐dose bupivacaine (≥10 mg, HB), low‐dose bupivacaine (<10 mg, LB) and combination of low‐dose bupivacaine and opioids (LBO). <hi rend="bold">Methods:</hi>
Databases of MEDLINE, EMBASE, and Cochrane Library were searched (updated on October 30, 2011). Primary endpoints were the incidence of intraoperative hypotension and analgesia efficacy. Pooled risk ratio (RR) or standard mean difference and their 95% confidence intervals (95% CI) were calculated. A RR <1 indicates that LB or LBO regimen is associated with less intraoperative complications and better anesthesia or analgesia efficacy. <hi rend="bold">Results:</hi>
A total of 11 randomized controlled trials including 605 parturients were analyzed. Results of this meta‐analysis showed that compared with HB regimen, LB regimen decreased the incidence of intraoperative hypotension (RR = 0.64, 95% CI: 0.42–0.96) with less satisfactory analgesia (fixed model, RR = 1.50, 95% CI: 1.14–1.98). LBO regimen significantly reduced the incidence of intraoperative hypotension (RR = 0.52, 95% CI: 0.33–0.82) with reliable analgesia efficacy (RR = 2.56, 95% CI: 0.77–8.48). <hi rend="bold">Conclusion:</hi>
Compared with conventional HB regimen and LB regimen, LBO regimen not only reduced intraoperative hypotension but also provided reliable analgesia. Therefore, LBO regimen should be considered as the preferred drug combination for spinal anesthesia in cesarean section.</p>
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<correspondenceTo>Quan Li, Ph.D., M.D., Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University, 301 Yanchang Middle Rd, Shanghai 200072, China.
Tel.: 86‐21‐66307531;
Fax: 86‐21‐66307531;
E‐mail: <email>quanligene@126.com</email>
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This meta‐analysis was undertaken to compare the three most common drug regimens of bupivacaine in spinal anesthesia for cesarean section: high‐dose bupivacaine (≥10 mg, HB), low‐dose bupivacaine (<10 mg, LB) and combination of low‐dose bupivacaine and opioids (LBO). <b>Methods:</b>
Databases of MEDLINE, EMBASE, and Cochrane Library were searched (updated on October 30, 2011). Primary endpoints were the incidence of intraoperative hypotension and analgesia efficacy. Pooled risk ratio (RR) or standard mean difference and their 95% confidence intervals (95% CI) were calculated. A RR <1 indicates that LB or LBO regimen is associated with less intraoperative complications and better anesthesia or analgesia efficacy. <b>Results:</b>
A total of 11 randomized controlled trials including 605 parturients were analyzed. Results of this meta‐analysis showed that compared with HB regimen, LB regimen decreased the incidence of intraoperative hypotension (RR = 0.64, 95% CI: 0.42–0.96) with less satisfactory analgesia (fixed model, RR = 1.50, 95% CI: 1.14–1.98). LBO regimen significantly reduced the incidence of intraoperative hypotension (RR = 0.52, 95% CI: 0.33–0.82) with reliable analgesia efficacy (RR = 2.56, 95% CI: 0.77–8.48). <b>Conclusion:</b>
Compared with conventional HB regimen and LB regimen, LBO regimen not only reduced intraoperative hypotension but also provided reliable analgesia. Therefore, LBO regimen should be considered as the preferred drug combination for spinal anesthesia in cesarean section.</p>
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<abstract>SUMMARY Aims: This meta‐analysis was undertaken to compare the three most common drug regimens of bupivacaine in spinal anesthesia for cesarean section: high‐dose bupivacaine (≥10 mg, HB), low‐dose bupivacaine (<10 mg, LB) and combination of low‐dose bupivacaine and opioids (LBO). Methods: Databases of MEDLINE, EMBASE, and Cochrane Library were searched (updated on October 30, 2011). Primary endpoints were the incidence of intraoperative hypotension and analgesia efficacy. Pooled risk ratio (RR) or standard mean difference and their 95% confidence intervals (95% CI) were calculated. A RR <1 indicates that LB or LBO regimen is associated with less intraoperative complications and better anesthesia or analgesia efficacy. Results: A total of 11 randomized controlled trials including 605 parturients were analyzed. Results of this meta‐analysis showed that compared with HB regimen, LB regimen decreased the incidence of intraoperative hypotension (RR = 0.64, 95% CI: 0.42–0.96) with less satisfactory analgesia (fixed model, RR = 1.50, 95% CI: 1.14–1.98). LBO regimen significantly reduced the incidence of intraoperative hypotension (RR = 0.52, 95% CI: 0.33–0.82) with reliable analgesia efficacy (RR = 2.56, 95% CI: 0.77–8.48). Conclusion: Compared with conventional HB regimen and LB regimen, LBO regimen not only reduced intraoperative hypotension but also provided reliable analgesia. Therefore, LBO regimen should be considered as the preferred drug combination for spinal anesthesia in cesarean section.</abstract>
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