A comparative study of three different doses of 0.5% hyperbaric bupivacaine for spinal anaesthesia in elective caesarean section.
We conducted a double-blind comparison of three doses (7.5 mg, 8.75 mg and 10 mg) of 0.5% hyperbaric bupivacaine in women undergoing elective caesarean under spinal anaesthesia. Sixty women were randomised into 3 groups of 20. Group A received 7.5 mg, group B 8.75 mg and C 10 mg of study drug. The time to maximum sensory blockade did not differ among the groups (P > 0.05). Mean time to start of regression of sensory block was greater in group C than in groups A and B (P < 0.001 and P < 0.05 respectively). Time required for complete regression of sensory block was longer in group C than in groups A and B (P < 0.001). Duration of motor block was greater in group C than in groups A and B (P < 0.001 and < 0.05 respectively). Neonatal outcome was good in all the groups. None of the patients in any group experienced pain before delivery. After delivery of the baby, however, group C women had a lower incidence of visceral pain than did groups A and B (P < 0.05). The incidence of hypotension was greater in groups B and C than in group A (P < 0.05). Group C women had a greater incidence of bradycardia than did groups A and B (P < 0.05). The 7.5-mg dose of 0.5% hyperbaric bupivacaine was observed to provide acceptable analgesia without any significant incidence of adverse effects such as maternal hypotension or bradycardia.
Department of Anaesthesia and Critical Care, Postgraduate Institute of Medical Sciences, Rohtak, India. gupta3@vsnl.com
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