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Year : 2018  |  Volume : 5  |  Issue : 3  |  Page : 231-239

Optimizing heavy marcaine dose for spinal anesthesia in short stature pregnant female individuals undergoing cesarean section

Department of Anesthesiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Ramy Mahrose
Department of Anesthesiology, Faculty of Medicine, Ain Shams University, Cairo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/roaic.roaic_98_17

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Background and objectives Hypotension after spinal anesthesia is still widespread in cesarean delivery, especially in pregnant women with short stature. The use of a reduced dose of local anesthesia allows adequate spinal anesthesia with minimal hypotension. We investigate the lowest dose of heavy bupivacaine that can be used to reduce the frequency of hypotension associated with adequate spinal anesthesia in short stature pregnant female individuals undergoing cesarean section. Patients and methods Sixty women scheduled for cesarean section were divided into three groups of patients (20 in each group) receiving spinal injections of 0.04 mg heavy bupivacaine/cm height (group A), 0.05 mg heavy bupivacaine/cm height (group B), and 0.06 mg heavy bupivacaine/cm height (group C). A decrease in systolic pressure greater than 20% of the baseline was considered low blood pressure and was treated with a bolus of 5–10 mg intravenous ephedrine. The quality of surgical anesthesia was assessed among groups. Results Groups B and C were assigned a higher sensory level block than group A after spinal anesthesia, and the difference was statistically significant (P<0.05). In group C, 18 (90%) patients developed a complete motor block, while in group B, 16 (80%) patients developed a complete motor block, compared with patients of group A in which only four (20%) patients developed complete motor block, and the difference between groups was statistically significant (P<0.05). The spinal block resulted in excellent surgical anesthesia in groups B and C compared with group A. Patients in group C were more likely to develop hypotension than patients in groups B and A. There was no significant statistical difference between the groups as regards neonatal outcome. Conclusions This study showed that the use of spinal anesthesia in pregnant women of short stature using heavy bupivacaine at a concentration of 0.05 mg/cm body weight showed a clear benefit in terms of adequate anesthesia and stable hemodynamics.

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