Hemodynamic behavior in subarachnoid anesthesia with Bupivacaine alone or combined with Fentanyl

Abstract

Introduction: Neuraxial anesthesia (epidural, subarachnoid) is a central specialized management technique that is chosen according to the type of patient, type of surgery and duration of surgery. Subarachnoid (or spinal) anesthesia provides complete, rapid, and reliable anesthesia, in a significant portion of the body, with a minimum dose of local anesthetic and for a predictable period of time. Objective: show scientific updates on general aspects of hemodynamic behavior with the use of Hyperbaric Bupivacaine alone or with fentanyl in subarachnoid anesthesia. Development of the topic: Hyperbaric Bupivacaine due to its pharmacological properties, among which: prolonged action, relatively low doses; make it one of the local anesthetics of choice. Fentanyl, for its part, is a lipophilic opioid, with a rapid onset of action, which is used as an adjuvant, with the purpose of reducing the dose of the local anesthetic, maintaining hemodynamic stability and reducing the appearance of major adverse effects. Conclusions: When using the technique of subarachnoid anesthesia with a local anesthetic combined with an opioid, these combine the speed, giving reliability of the subarachnoid block of the first, with the benefits of opioids to extend the duration and/or extension of anesthesia/analgesia, due to these pharmacological advantages of the administration of small doses used of both drugs, better hemodynamic stability is achieved.