Spinal Anestezi ile Sezaryen Doğumda İzobarik Bupivakain ile Hiperbarik Bupivakain Kullanımının Değerlendirilmesi/Evaluation of the Use of Isobaric Bupivacaine and Hyperbaric Bupivacaine in Cesarean Section With Spinal Anesthesia

Spinal anesthesia (SA) is widely used in cesarean delivery (CD) patients. SA application has many advantages as well as disadvantages. Different SA procedures have been developed to minimize potential complications. In this study, the effects of different types of bupivacaine on possible complications and block levels in pregnant women undergoing SA and CD were compared. A prospective study was planned, covering mothers who made an elective CD between 1 January and 28 February 2020. One group was administered isobaric bupivacaine and the other was applied hyperbaric bupivacaine to observe its maternal effects. After SA, hemodynamic changes, sensory and motor block levels were compared. Participants were randomly selected by the closed envelope method. Data analysis was performed using SPSS (version 23), with statistics Binomial test, Mann-Whitney U-test and Chi-Square test. For all tests, p <0.05 value was considered statistically significant. The incidence of hypotension was found to be higher in the isobaric group (74%) than in the hyperbaric group (56%) (p = 0.046). In the beginning, there was no statistically significant difference in mean blood pressure value; however, statistically significant changes were observed between the groups, except for the 30th minute, in all study timing after SA (respectively; p=0.037, p=0.045, p=0.012, p=0.043, p=0.017, p=0.155). There was no statistically significant difference in heart rate variability in all periods (p> 0.05). Ephedrine was required to be used in 14 (%28) patients in the isobaric group and 5 (%10) patients in the hyperbaric group (p=0.020). In our study, a higher level of sensory blockade was detected in the isobaric group (p=0,045). However, the regression of the sensory block to T12 was significantly earlier in the hyperbaric group (p=0.017). No significant difference was observed between the groups in terms of the termination time of the motor block (p=0,156). In patients undergoing SA for SD, hyperbaric bupivacaine provides advantages with less hypotension, while isobaric bupivacaine provides longer motor and sensory block.