Comparison of Three Different Doses of 0.75% Hyperbaric Bupivacaine for Intraoperative Analgesia in Elective Cesarean Sections

Abstract

Background:  Spinal anaesthesia is a safe and prefer-red mode of anaesthesia for cesarean sections all over the world. In this study we compared the intra-opera-tive analgesia of three different doses of hyperbaric bupivacaine in pregnant patients undergoing elective cesarean sections.

Patients and Methods:  90 pregnant patients coming for elective cesarean sections, fulfilling inclusion crite-ria were included in this study. They were divided into 3 groups of 30 each. Group A received 1.4 ml, group B 1.6 ml and group C 1.8 ml of 0.75% hyperbaric bupivacaine. All patients were preloaded with 500 ml Ringer's lactate and spinal anaesthesia was adminis-tered in sitting position. 30 degree head down position and wedge under right hip was used in all. Vitals were taken and documented on the proforma. Sensory level was checked by using pin prick in all patients.

      Surgical anaesthesia was taken as main outcome measured by using ANOVA test with p < 0.05 con-sidered as significant. Peak sensory level, motor block, hypotension episodes, vomiting episodes, total amount of ephedrine used and analgesic drugs required or not were additionally noted.

Results:  All the patients of three groups were similar in age (P = 0.057), weight (P = 0.148), height (P = 0.371), gestational age (P = 0.656), level at which spi-nal was administered (P = 0.236). Surgical analgesia (P = 0.848) was comparable among all groups. Freque-ncy of hypotension (P =0.834), peak sensory level and motor block (P = 0.053), episodes of vomiting (P = 0.306), total amount of ephedrine used (P = 0.510), additional use of analgesic drugs (P = 0.700) were also equal. All the newborns were active and there was no statistical difference in APGAR at 1 min (P = 0.238) and 5 min (P = 0.680).

Conclusion:  Three different doses of 0.75% hyper-baric bupivacaine used in parturient coming for elec-tive cesarean sections failed to show any statistically

significant difference in the quality of analgesia.

Key Words:  Cesarean section; spinal; hyperbaric Bupivacaine; doses.