Intrathecal isobaric versus hyperbaric bupivacaine for elective Caesarean section

ABSTRACT

To compare the results of isobaric bupivacaine [0.5%] with hyperbaric bupivacaine [0.75%] in cases of elective Caesarean Section, in respect of time to sensory analgesia, highest level of sensory block, haemodynamic effects, and complications. Interventional, experimental study from March 2003 to March 2004. Department of Anaesthesiology and Surgical Intensive Care Unit, Dow University of Health Sciences and Civil Hospital, Karachi. Sixty pregnant patients scheduled for elective Caesarean Section. The patients were randomly assigned to receive either 0.5% isobaric bupivacaine [Group-1B] or 0.75% hyperbaric bupivacaine [Group-HB] via intrathecal route. The time of onset of block, highest level of sensory block, cardio-respiratory data, duration of analgesia and complications were recorded during surgery. Results: The time taken to reach T4 sensory analgesia in Group-IB was 6 +/- 6.43 minutes as compared to 6.93 +/- .7.8 minutes in Group-HB, while the highest sensory level achieved in Group-IB was TI and in Group-HB T2. The lowest systolic blood pressure recorded in Group-IB was 83.27 +/- 12.69 mmHg and in Group-HB 114.33 + 13.83 mm Hg, the difference being significant [p < 0.05]. There was a higher incidence of complications in Group-IB as compared to Group-HB like high spinal analgesia, vomiting and discomfort. Intrathecal block showed a greater reduction in the systolic blood pressure, and associated complications, with Isobaric Bupivacaine as compared to Hyperbaric Bupivacaine