Comparison of Hemodynamic Profiles and Onset and Offset of Motor and Sensory Blockade between 2% Hyperbaric Prilocaine and 0.5% Hyperbaric Bupivacaine for Spinal Anesthesia in Scheduled Cesarean Sections: A Double-Blind, Randomized Clinical Trial

Abstract Background: Hyperbaric prilocaine is claimed to have a more stable hemodynamic profile with a faster onset and faster recovery or offset for both motor and sensory blockade than bupivacaine. The goal of this study was to compare the hemodynamic profile and onset and offset of motor and sensory blockade between hyperbaric prilocaine and hyperbaric bupivacaine for scheduled cesarean section. Materials and Methods: This research is an experimental study, a single-centered and double-blinded randomized clinical trial. The independent variable was the type of spinal anesthesia administered, either 2% hyperbaric prilocaine or 0.5% hyperbaric bupivacaine, during scheduled cesarean section procedures. The dependent variables included the hemodynamic response and the onset and offset of the anesthetic effect. Results: There were 58 subjects with 29 subjects in each group. The hemodynamic profile between the two groups in this study obtained equivalent results, and 12 patients experienced episodes of hypotension in each group ( P = 0.605). The onset result in the prilocaine group was 1 min faster than the bupivacaine group with a median (interquartile range [IQR]) (4 min [2] vs. 5 min [1], P = 0.189). The offset result in the prilocaine group was 50 min faster than the bupivacaine group with a median (IQR) (90 min [18] vs. 140 min [26], P = 0.001). Conclusion: This research shows that hyperbaric prilocaine 2% induces a significantly shorter motor block compared with hyperbaric bupivacaine 0.5%, with a similar onset. There were no differences in terms of hemodynamic stability and side effects or impact on newborns between the two groups.