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Year : 2019  |  Volume : 13  |  Issue : 4  |  Page : 663-668

Large dose bupivacaine 0.5% versus small dose in elective cesarean section

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

Correspondence Address:
Hassan Mohamed Ali
Department of Anesthesia, Faculty of Medicine, Cairo University, Kasr Elaine Street, Giza, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aer.AER_131_19

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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.

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