title: Correlation of bupivacaine 0.5% dose and conversion from spinal anesthesia to general anesthesia in cesarean sections.
abstract: BACKGROUND
  Failed spinal anesthesia for cesarean sections may require conversion to general anesthesia. The aim of this study was to determine whether the administered spinal bupivacaine dose for performing a cesarean section under spinal anesthesia was related to the conversion rate to general anesthesia.
  
  
  METHODS
  Retrospective analysis was performed on 1252 electronic data and file of patients who underwent a cesarean section under spinal anesthesia between 2004 and 2011.
  
  
  RESULTS
  In 15 patients, spinal anesthesia was converted into general anesthesia due to block failure. Patients in whom a bupivacaine dose of 8 mg or smaller was administered had significantly higher conversion rate (3/61 (4.9%) patients and 12/1191 (1.0%) patients, respectively; p < 0.05.). The relative risk of conversion with a 8 mg dose or lower is 4.88 (95% CI 1.41 - 16.85).
  
  
  CONCLUSIONS
  This retrospective study shows that a low dose administration a bupivacaine 0.5% for spinal anesthesia in cesarean section patients elicits significantly more frequent conversion to general anesthesia.
authors.forename: D
authors.initials: D
authors.lastname: Seljogi
authors.forename: A P
authors.initials: AP
authors.lastname: Wolff
authors.forename: G J
authors.initials: GJ
authors.lastname: Scheffer
authors.forename: G J
authors.initials: GJ
authors.lastname: van Geffen
authors.forename: J
authors.initials: J
authors.lastname: Bruhn
mesh_terms: D000768:Anesthesia, General / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage*; D002585:Cesarean Section / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D017211:Treatment Failure
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine