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Anesth Essays Res. 2019 Oct-Dec;13(4):663-668. doi: 10.4103/aer.AER_131_19. Epub 2019 Dec 16.

Large Dose Bupivacaine 0.5% versus Small Dose in Elective Cesarean Section.

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1
Department of Anesthesia, Faculty of Medicine, Cairo University, Giza, Cairo, Egypt.

Abstract

Background and Aim:

The spinal anesthesia in a cesarean section is still presenting a challenge to the anesthetist in the form of either severe hypotension from large bupivacaine dose or insufficient satisfactory anesthesia level conditions as a result of small bupivacaine dose. In this study, we tried to solve this challenge by increasing the dose of bupivacaine to achieve a proper spinal level accompanied by prolonged sitting up to avoid hypotension.

Patients and Methods:

We included 53 patients in this study whom were randomly divided into two groups, namely Group B and Group C. In Group B (25 patients), each patient received 3 mL of bupivacaine and left 5 min sitting up, whereas in Group C (28 patients), each patient received 2.5 mL of bupivacaine and was asked to lie supine immediately. Both groups were tested for hypotension, ephedrine dose, and sensory block level.

Results:

The present study showed a statistically significant lower dose of ephedrine which was given in Group B (7.2 ± 15.684 mg in Group B versus 27.86 ± 12.04 mg in Group C with P < 0.05). The proper anesthesia level was achieved equally in both groups.

Conclusions:

Large dose 15 mg of bupivacaine with the prolonged sitting position will lead to fewer incidences of hypotension and proper anesthesia block.

KEYWORDS:

Ephedrine; hypotension; spinal anesthesia

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