مقايسه وضعيت هموديناميك و عوارض بي حسي نخاعي با ليدوكائين و بوپيوا كائين در عمل جراحي سزارين

A comparison of the hemodynamic effects and complications of Lidocaine and Bupiva-caine for spinal anesthesia in cesarean surgery

Background: Spinal anesthesia recently has gained popularity for cesarean delivery. It is a simple and economical method, and a small dose of local anesthetic produces an effective block with complete muscle relaxation and reduces blood loss during surgery. Materials and Methods : To evaluate the effect of Lidocaine 5% and Bupivacaine 0.5% on hemody-namic variables and complications in cesarean surgery with spinal anesthesia, we studied prospectively 80 patients (age range 21-38) as a randomized, double blind, clinical trial with ASA physical status I that candidate for elective or emergency cesarean delivery. The patients divided into two groups, group I (n=40) received lidocaine %5 (75 mg), group II (n=40) received bupivacaine 0.5% (12.5mg) for spinal anesthesia undergoing cesarean surgery. We use Chi square and independent t-test for compression between two groups. P-value less than 0.05 consider significance. Results: A total of 80 women were studied with the mean age of lidocaine and bupivacaine were 28.5+4 and 27.8+4.6 years, respectively. The groups did not differ in age, weight, height and demographic characteristics (p-value>0.05). Comparison of the mean systolic blood pressure changes before and after spinal anesthesia showed no significant difference between two groups (P value <0.05). Our result showed that patients remained longer in the post- anesthesia care unit (PACU) after bupivacain spinal block due to prolonging recovery of motor function (p-value <0.01). Conclusion: We concluded the both methods could be used safely in uncomplicated cesarean delivery. Although that spinal block with bupivacaine compared with lidocaine may provide better duration of sensory anesthesia for uncomplicated cesarean section but due to disturbance in mother-infant contact and delayed breast feeding not appropriate choice for cesarean delivery.