Combination of Low‐Dose Bupivacaine and Opioids Provides Satisfactory Analgesia with Less Intraoperative Hypotension for Spinal Anesthesia in Cesarean Section

摘要

SUMMARY Aims: This meta‐analysis was undertaken to compare the three most common drug regimens of bupivacaine in spinal anesthesia for cesarean section: high‐dose bupivacaine (≥10 mg, HB), low‐dose bupivacaine (Methods: Databases of MEDLINE, EMBASE, and Cochrane Library were searched (updated on October 30, 2011). Primary endpoints were the incidence of intraoperative hypotension and analgesia efficacy. Pooled risk ratio (RR) or standard mean difference and their 95% confidence intervals (95% CI) were calculated. A RR Results: A total of 11 randomized controlled trials including 605 parturients were analyzed. Results of this meta‐analysis showed that compared with HB regimen, LB regimen decreased the incidence of intraoperative hypotension (RR = 0.64, 95% CI: 0.42–0.96) with less satisfactory analgesia (fixed model, RR = 1.50, 95% CI: 1.14–1.98). LBO regimen significantly reduced the incidence of intraoperative hypotension (RR = 0.52, 95% CI: 0.33–0.82) with reliable analgesia efficacy (RR = 2.56, 95% CI: 0.77–8.48). Conclusion: Compared with conventional HB regimen and LB regimen, LBO regimen not only reduced intraoperative hypotension but also provided reliable analgesia. Therefore, LBO regimen should be considered as the preferred drug combination for spinal anesthesia in cesarean section.