Effect of Spinal Low Dose Bupivacaine-Sufentanyl for Cesarean Section in Preeclamptic Parturients on Neonatal Outcome.

Background: We studied markers of both neonatal and maternal hemodynamic condition in preeclamptic patients receiving spinal anesthesia for cesarean section and evaluated primary neonatal outcome with Apgar scores. Methods: 44 preeclamptic patients randomized into two groups of 22 patients were enrolled in this trial in Tabriz Alzahra Hospital. The trials were conducted from December 2005 to August 2006. In group A, spinal anesthesia was performed with 6mg of bupivacaine and 3.3 ?g of sufentanyl, while Group B received 12mg of bupivacaine alone. Hypotension was treated with intravenous ephedrine boluses of 2.5-5 mg, up to maximum of 50 mg. After delivery, 1st and 5th minute Apgar scores were evaluated and umbilical arterial blood gas samples were drawn and analyzed. Results: All patients had satisfactory anesthesia. Five of 22 patients in group A required 5mg of ephedrine, while 17 of the 22 patients in group B required ephedrine. There was no significant between group differences for 1st and 5th minute Apgar scores (P=0.760, P=0.349) and umbilical arterial blood gas markers (p > 0.05). Conclusion: A 6mg dose of bupivacaine in combination with 3.3 ?g of sufentanyl provided satisfactory spinal anesthesia for cesarean section in preeclamptic patients, and caused substantially less hypotension than 12 mg of bupivacaine alone. There was no difference in immediate neonatal outcome, as assessed by Apgar scores and neonatal pH and base deficit.