Minimum Appropriate Dose of Lidocaine with a Fixed Dose of Sufentanil Epinephrine Used for Spinal Anesthesia in Caesarian Section


Parisa Golfam 1 , Mitra Yari 2 , * , Hamid Reza Bakhtiyari 1

1 Department of Anesthesiology, Kermanshah University of Medical Sciences, Iran

2 Clinical Research Development Center, Kermanshah University of Medical Sciences, [email protected], Iran

How to Cite: Golfam P, Yari M, Bakhtiyari H R. Minimum Appropriate Dose of Lidocaine with a Fixed Dose of Sufentanil Epinephrine Used for Spinal Anesthesia in Caesarian Section, Anesth Pain Med. Online ahead of Print ; 2(3):123-126. doi: 10.5812/aapm.7810.


Anesthesiology and Pain Medicine: 2 (3); 123-126
Published Online: January 1, 2013
Article Type: Research Article
Received: August 18, 2012
Accepted: October 9, 2012


Background: Caesarian section is a commonplace surgery in females for which spinal anesthesia is the preferred method. The local anesthetic medications used in the surgery are often associated with complications such as nausea, vomiting, dyspnea, hypotension, and bradycardia. In the present study, we decreased the dose of the anesthetic drug and added an opioid instead.

Objectives: We tried to find an appropriate combination of medications required for optimal anesthesia with minimum complications.

Patients and Methods: One hundred twenty six candidates for C/S with first and second class ASA aged 18-35 years were randomly divided into three groups. All patients received sufentanil (2.5 g) and epinephrine (100 g) doses but the lidocaine doses were respectively 50 mg, 60 mg and 75 mg in the groups 1, 2 and 3. Complications including hypotension, bradycardia, dyspnea, nausea, vomiting, and anesthesia quality were recorded and statistically analyzed.

Results: The level of anesthesia was significantly different between groups. By reducing the lidocaine dose, patients with anesthesia level under the nipple increased but the surgeon and the patient were satisfied with the results. Nausea, vomiting, and dyspnea was degraded by decreasing the lidocaine dose especially in the 50 mg group. The need to use ephedrine was directly associated with the lidocaine. However, the need to use atropine was not significantly different between groups. Pruritus was not significantly different as well.

Conclusions: It seems that reducing the lidocaine dose, when combined with sufentanil, decreases most complications of spinal anesthesia such as hypotension, dyspnea, nausea, and vomiting while preserving anesthesia quality.

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