COMPARISON BETWEEN 0.5% AND 0.75% HYPERBARIC BUPIVACAINE GIVEN INTRA-THECALLY IN ELECTIVE CAESAREAN SECTION

Abstract

Objective: To determine hemodynamic changes by using 0.75% and 0.50% hy- perbaric bupivacaine for spinal anesthesia in caesarean section.

Methodology: In this randomized clinical trial 200 patients of elective cesar- ean section with primigravida having age 20-40 years were included. Group I patients received 0.5% hyperbaric bupivacaine for spinal anesthesia and Group II patients received 0.75% hyperbaric bupivacaine for induction. In all patients, a total of 10.5 mg dose of hyperbaric bupivacaine was given. Patient's systol- ic blood pressure (SBP) and heart rate were noted before spinal anesthesia, immediately after anesthesia, after 5 minutes and 10 minutes of anesthesia. Necessity of rescue ephedrine and incidence of nausea/vomiting was noted in all patients.

Results: After 5 minutes of spinal anesthesia, SBP significantly dropped in pa- tients who received 0.75% hyperbaric bupivacaine as compared to patients who received 0.5% bupivacaine 107.95 ±13.49 mmHg vs. 112.76±11.49 mmHg, respectively with p value 0.007. After 10 minutes of anesthesia there was no difference in SBP in both groups. There was significant difference in heart rate after 10 minutes of anesthesia and decrease in heart rate was more in group II (p value 0.006). Nausea/vomiting occurred in 23% patients in group II and in only 1% patients in group I. Rescue ephedrine was given in 21% patients in group I and 35% patients in group II. Level of block was T6 in 25% patients in group I and 47% patients in group II (p value 0.001).

Conclusion: 0.5% hyperbaric bupivacaine was associated with better hemody- namic stability and reduced risk of bradycardia, necessity of rescue ephedrine and nausea/vomiting.