Evaluation effectiveness and safety of Hyperbaric and Isobaric Bupivacaine for spinal anesthesia for noncesarean delivery surgery: A Systematic Review and Meta-Analysis

Abstract

Background and aim:In the present study, we tried to provide comprehensive results by evaluating the results of studies and summarizing the best evidence, the effectiveness of hyperbaric bupivacaine compared to isobaric Bupivacaine for spinal anesthesia. The findings may help anesthesiologists choose the best formulation for spinal anesthesia. Therefore the aim of present Systematic Review and Meta-Analysis was evaluation effectiveness and safety of Hyperbaric and Isobaric Bupivacaine for spinal anesthesia for noncesarean delivery surgery.   Method:From the electronic databases, PubMed, Cochrane Library, Embase, ISI have been used to perform a systematic literature between 2001 andJanuary 2021. Risk ratiowith 95% confidence interval (CI), fixed effect model and Mantel-Haenszel methodwere calculated. The Meta analysis have been evaluated with the statistical software Stata/MP v.16 (The fastest version of Stata).

Result:A total of 314potentially relevant titles and abstracts were found during the electronic search. Finally, fourstudies required for this systematic review.  Meta-analysis showed, there was no statistically significant difference between two groups about incidence of hypotension(RR, 0.09 95% CI -0.75, 0.93. P=0.96). Duration of the motor block was longer in HB group(MD, 30.53 min 95% CI 20.79, 40.26. P=0.00) and the duration of sensory block was significantly higher with the IB vs HB with significant inverse correlation(MD, -40.07 min 95% CI -47.84, -32.30. P=0.00).

Conclusion:due to the low quality of the existing studies, sufficient evidence could not be provided and results should be treated with caution.