Extradural bupivacaine or lignocaine anaesthesia for elective caesarean section: the role of maternal posture.
Extradural anaesthesia was induced in 64 patients in either the sitting or the lateral position, for elective Caesarean section with either 0.5% plain bupivacaine or 2% lignocaine with adrenaline 1 in 200,000. Onset was significantly shorter and a significantly greater number of patients were ready for surgery within 35 min following injection of lignocaine in the lateral position. Hypotension (defined as a 25% or greater reduction in arterial pressure) occurred in 36% of patients. Significantly more patients who had received the first injection of local anaesthetic agent in the sitting position required ephedrine to correct maternal hypotension. Most frequently, hypotension coincided with transfer of patients to theatre and thus was associated with movement of the patient in the presence of extensive sympathetic block.
Department of Anaesthesia, Western Infirmary, Glasgow.
J A
JA
Reid
J
J
Thorburn
D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D002045:Bupivacaine / Q000009:adverse effects; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008012:Lidocaine / Q000009:adverse effects; D011187:Posture; D011247:Pregnancy
D008012:Lidocaine; D002045:Bupivacaine