Abstract:
Introduction: Study compare spinal anesthesia using hyperbaric bupivacine (0.5% - 0.75%) between fixed dose and height adjusted dose during elective cesarean section.
Methods: Hundred parturients who had given their consent and were scheduled for elective cesarean section under spinal anesthesia, were divided into four groups – first group received 0.5% hyperbaric bupivacine fixed dose, the second group received 0.5% hyperbaric bupivacine in a dose adjusted to the height, the third received 0.75% hyperbaric bupivacine fixed dose, the fourth group received 0.75% hyperbaric bupivacine in a dose adjusted to height. The anesthesia onset time, haemodynamic changes, side effects and fetal outcome observed.
Results: spinal block provide excellent surgical anesthesia in all patients. Anesthesia onset time is longer in adjusted than fixed groups, in 0.5% (5 0.816 vs 3.84 0.746) (P < 0.001) and in 0.75% (3.76 0.778 vs 3.28 0.741) (P 0.03), the motor block was less dense and of short duration in adjusted groups with decrease in the length of post – anesthetic care unit stay. There is decrease in incidence and severity of hypotention with decrease in total dose of vasopressors used in adjusted than fixed dose groups in 0.5% ephedrine (10 6.123 vs 19.6 12) mg (p 0.008) and in 0.75% phenylephrine (0.268 0.07 vs 0.596 0.2) mg (P < 0.004), Nausea and vomiting were more frequent in fixed dose groups.
Conclusion: Adjusting dose of hyperbaric bupivacine (0.5% - 0.75%) to patient's height, decreases the dose of bupivacine in use, it also provide adequate anesthesia for elective cesarean section with decrease the use of vasopressors, the incidence and severity of maternal hypotention also markedly reduced.
Keywords: Cesarean section, height, spinal anesthesia, local anesthesia.
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