The planned cesarean section is an intervention with a standard operating time of less than 40 minutes in trained teams. Hyperbaric Bupivacaine is the local anesthetic (LA) reference for these operations. But the duration of its motor block is generally greater than 3 hours. The purpose of this study is to show a reduction in motor block time with hyperbaric Prilocaine by at least 30 minutes, which would allow mothers and their children to return to the maternity ward earlier and thus improve the circulation of patients within the maternity's PACU.
Prospective study, randomized into two parallel groups (Hyperbaric Prilocaïne versus hyperbaric Bupivacaine), double-blind, monocentric (Clinique Saint Roch in Montpellier). The number of subjects required is 50 patients, 25 per group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
50
spinal anesthesia for planned cesarean sections
Uhmontpellier
Montpellier, France
RECRUITINGduration of motor block
To compare the duration of motor block after spinal anesthesia with hyperbaric Prilocaïne versus hyperbaric Bupivacaine This evaluation is done every 15 min from the entrance to the recovery room (PACU); the motor block stops being evaluated when the modified bromination score reaches 4
Time frame: up to 6 hours
The upper sensory level
The upper sensory level obtained 15 minutes after the LA injection
Time frame: 15 minutes after the LA injection
Hypotensive episodes
Hypotensive episodes
Time frame: 1 day
The time between injection and incision
The time between injection and incision
Time frame: 1 day
The duration of the intervention
The duration of the intervention
Time frame: 1 day
The time to return to the standard maternity ward
The time to return to the standard maternity ward
Time frame: 1 day
APGAR score of newborns at birth
APGAR score of newborns at birth. L'APGAR Apgar score is a method to quickly summarize the health of newborn children. The Apgar scale is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria are summarized using words chosen to form a backronym (Appearance, Pulse, Grimace, Activity, Respiration). The test is generally done at one and five minutes after birth, and may be repeated later if the score is and remains low. Scores 7 and above are generally normal, 4 to 6 fairly low, and 3 and below are generally regarded as critically low.
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Time frame: 1 day
The delay between spinal anesthesia and the first emergency analgesic injection
The delay between spinal anesthesia and the first emergency analgesic injection
Time frame: 1 day
Assessment of pain (VAS)
Pain on arrival and departure of PACU and at 24 hours. Pain will be assessedby VAS (Visual Analogue Scale); Patients rate pain on VAS from 0-10, 0 being no pain and 10 being the worst pain imaginable..
Time frame: 1 day
The delay between spinal anesthesia and the first injection of second-line analgesia
The delay between spinal anesthesia and the first injection of second-line analgesia : delay between spinal anesthesia ans the need of rescue analgesia
Time frame: 1 day
The presence of neuro-sensory disorders within 24 hours postoperatively
The presence of neuro-sensory disorders within 24 hours postoperatively
Time frame: 1 day
The presence of post lumbar puncture syndrome
The presence of post lumbar puncture syndrome
Time frame: 1 day
score de satisfaction
Patient satisfaction score at 24 hours will be assessed by VAS (Visual Analogue Scale); Patients rate satisfaction on VAS from 0-10, 0 being no satisfaction and 10 being total satisfaction
Time frame: 1 day
Statifaction of the Surgeon
The surgeon assessed his satisfaction while the cesarien section. The surgeon satisfaction score at 24 hours will be assessed by VAS (Visual Analogue Scale); Surgeon rate satisfaction on VAS from 0-10, 0 being no satisfaction and 10 being total satisfaction.
Time frame: 1 day