EFFECTS OF HEIGHT ADJUSTED DOSE OF 0.75 PERCENT BUPIVACAINE ON PREVENTION OF HYPOTENSION AFTER INTRATHECAL ANAESTHESIA FOR CAESAREAN SECTION

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Posted in Volume 15 - Number 4 Suppl

ALI SARFRAZ SIDDIQUI, SAFIA ZAFAR SIDDIQUI, SARWAR JAMIL SIDDIQUI, SADQA AFTAB, SAEEDA HAIDER

ABSTRACT | Full Text PDF

OBJECTIVE: To assess the effects of height adjusted dose of bupivacaine hydrochloride 0.75% hyperbaric intrathecally for adequate block  and severity of haemodynamic complications in caesarean section.

STUDY DESIGN:  It was a quasi experimental study.

PLACE AND DURATION OF STUDY: Department of Anaesthesiology, Surgical intensive care  unit and pain management, Dow Medical College & Civil Hospital Karachi, Dow University of Health Sciences from 1st

July 2006 to 31st  December 2006.

PATIENTS AND METHOD: Ninety nine pregnant patients aged 18-35 years, ASA physical status I and II presenting for caesarean section were randomly allocated to receive 1.2ml (Group A), 1.4ml (Group B) or 1.6ml (Group C) of bupivacaine 0.75% intrathecally. Spinal anaesthesia was given to all full term pregnant women with standard technique after preloading with 15ml/kg lactated Ringer’s solution in sitting position. Patient’s name, age, weight, height, ASA status, indication for caesarean section, heart rate and blood pressure were noted and after injection of bupivacaine intrathecally patients were placed supine with 15 degree left lateral tilt. Five minutes after injection, level of block (sympathetic, sensory and motor) was assessed. Heart rate, blood pressure, oxygen saturation and ECG were monitored throughout surgery. Data was entered and analyzed by using SPSS.10.

RESULTS:  Height of sensory block reaches upto T6  or higher in most of the patients of all the three study groups i.e. 28 patients in group A, 31 patients in group B while 33 patients in group C. Hypotension occurred in total 21 patients out of 99 patients (9 patients in group A, 5 patients in group B while 7 patients in group C).Out of these 21 patients, 18 responded to extra fluid and only 3 patients required injection ephedrine to maintain systolic blood pressure above 100 mm of Hg . Bradycardia was observed in only one patient of group B.

CONCLUSION:  The study showed that height adjusted dose of bupivacaine hydrochloride 0.75% (hyperbaric) provides adequate sensory level of anaesthesia for caesarean section and reduces the incidence and severity of haemodynamic complications.