ntroduction: 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. |
