• Angélica de Fátima de Assunção Braga, José Aristeu Fachini Frias, Franklin Sarmento da Silva Braga, and Daniela Roncoletta da Silva Pinto.
• Seção de Anestesia, CAISM, UNICAMP.
• Rev Bras Anestesiol. 2010 Mar 1;60(2):121-9, 69-73.

Background And ObjectivesSeveral factors affect the cephalad dispersion of the anesthetic solution in the subarachnoid space; among them, physiological changes of pregnancy and the dose and volume of the local anesthetics should be mentioned. The objective of this study was to assess the effectivity and side effects of different volumes of the subarachnoid administration of the association of hyperbaric bupivacaine and sufentanil in cesarean sections.MethodsForty patients, ASA I and II, undergoing elective cesarean section under spinal block were divided in two groups, according to the volume of the anesthetic solution: Group I (4 mL) and Group II (3 mL). The association of hyperbaric bupivacaine (10 mg(2) mL) and sufentanil (5 microg-1 mL) was used in both groups. In Group I, 1 mL of NS was added to the solution to achieve the volume of 4 mL. The following parameters were evaluated: latency of the blockade; upper limit of the sensorial blockade; degree of motor blockade; time for regression of the motor blockade; total duration of analgesia; maternal side effects; and neonatal repercussions.ResultsLatency, the upper limit of the sensorial blockade, and the degree and time for regression of the motor blockade were similar in both groups; duration of analgesia was greater in Group I than in Group II, which was statistically significant. The incidence of side effects was similar in both groups. Maternal cardiocirculatory changes and neonatal repercussions were not observed.ConclusionsFour milliliter of anesthetic solution composed of hyperbaric bupivacaine, 10 mg, associated with 5 microg of sufentanil was more effective than 3 ml of the same solution, providing better intra-and postoperative analgesia without maternal-fetal repercussions.

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