title: Extension of epidural blockade for emergency caesarean section. Assessment of a bolus dose of bupivacaine 0.5% 10 ml following an infusion of 0.1% for analgesia in labour.
abstract: A safe and predictable method by which an epidural infusion sufficient for pain control in labour can be rapidly converted to a more intense block adequate for emergency Caesarean section continues to present a challenge. A prospective study was undertaken. The routine use of a bolus dose of 10 ml of 0.5% bupivacaine was assessed as a top-up for emergency Caesarean section following a 0.1% infusion for labour. This produced an adequate block in 11 out of 18 patients. There were no significant differences in duration of infusion, cumulative local anaesthetic dose or pre-existing block height in these patients when compared with the remaining seven patients who required an additional top-up.
authors.affiliation: Department of Anaesthetics, Eastern General Hospital, Edinburgh.
authors.forename: M A
authors.initials: MA
authors.lastname: Dickson
authors.forename: J
authors.initials: J
authors.lastname: Jenkins
mesh_terms: D000293:Adolescent; D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D002045:Bupivacaine / Q000008:administration & dosage; D002585:Cesarean Section; D004630:Emergencies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D002045:Bupivacaine