Related Experiment Videos
Epidural mepivacaine for cesarean section: effects of a pH-adjusted solution
G Capogna1, D Celleno, G Varrassi
1Department of Anesthesiology, Fatebenefratelli Isola Tiberina General Hospital, Rome, Italy.
Study Objective:
To determine the clinical effects of the alkalinization of 2% mepivacaine with epinephrine used for epidural block during cesarean section.
Design:
Randomized, double-blind, placebo-controlled (standard commercial preparation of 2% mepivacaine with epinephrine) study.
Setting:
Inpatient obstetric department at a general hospital.
Patients:
Seventy patients scheduled for elective cesarean section under epidural anesthesia.
Interventions:
Two groups of 35 patients each receiving either the standard commercial preparation of mepivacaine or the pH-adjusted solution (prepared with the addition of 0.1 meq/ml of sodium bicarbonate to the standard commercial solution).
Measurements And Main Results:
Measurements of sensory (pinprick) and motor (Bromage's criteria) block were taken at 1- to 2-minute intervals beginning after the completion of the epidural injection. Increasing the pH of the mepivacaine resulted in a significant shortening of the time of analgesia onset (9.3 minutes compared with 16.01 minutes, p less than 0.01) and of peak effect (11.1 minutes compared with 21.2 minutes, p less than 0.01). The alkalinization did not affect duration of the block, intensity of motor block, or mean dose of local anesthetic used.
Conclusion:
The alkalinization allowed the surgery to proceed more rapidly, significantly decreasing the time interval between epidural block and delivery of the infant.