Fixed-dose versus height and weight-adjusted dose of intrathecal 0.5% hyperbaric bupivacaine in elective cesarean section: A comparative study

Authors

  • Kiran Kumar K.C. Nepal Police Hospital, Maharajgunj, Kathmandu 44600, Nepal https://orcid.org/0000-0003-1459-1385
  • Amir Babu Shrestha Paropakar Maternity and Women Hospital, Thapathali, Kathmandu 44600, Nepal
  • Sangeeta Shrestha Paropakar Maternity and Women Hospital, Thapathali, Kathmandu 44600, Nepal

DOI:

https://doi.org/10.3126/jsan.v6i2.27327

Keywords:

Height Adjusted Dose, Spinal Anesthesia, Cesarean section, Harten Chart

Abstract

Background: Spinal anesthesia is the preferred anesthetic technique for cesarean deliveries. But there is a dosage dilemma regarding block to the desired level and preventing hypotension. We aim to study effects of fixed dose with height and weight-adjusted dose of intrathecal 0.5% hyperbaric bupivacaine during elective cesarean section.

Methods: Eighty-eight singleton term parturients were enrolled and divided into two groups, Group FD (Fixed Dose) and CD (Calculated Dose) in this prospective, double-blind, randomized controlled trial. Group FD received 2.2 ml and CD received a height and weight adjusted calculated dose based on Harten's chart. Hemodynamic changes, onset time to sensory block to T6, maximum block in 20 minutes, and adverse effects were compared.

Results: There was a significant reduction in median drug dosage of 11mg in FD versus 9 mg in CD group. The decrease in the MAP was less in group CD (14.5±2.98) mmHg compared to (17.6±4.66) mmHg in group FD (P= 0.03). The median onset time of spinal block to T6 in group FD of 2 minutes with IQR (2-3) was faster than Group CD 4 minutes with IQR (3-5). The spinal block extended above T4 in the larger number of parturients 23 (52 %) in Group FD than in three (6.8%) in group CD (p<0.05). Significantly larger number 20 (45.45 %) in group FD developed hypotension than seven (15.9 %) in Group CD. Bradycardia and vomiting were also found in group FD.

Conclusions: This calculated dose provided the desired level of the spinal block and also restricted spinal block level with a distinct advantage of less hypotension.

Downloads

Download data is not yet available.
Abstract
432
pdf
318

Author Biographies

Kiran Kumar K.C., Nepal Police Hospital, Maharajgunj, Kathmandu 44600, Nepal

Anesthesiologist

Amir Babu Shrestha, Paropakar Maternity and Women Hospital, Thapathali, Kathmandu 44600, Nepal

Senior Consultant Anesthesiologist

Sangeeta Shrestha, Paropakar Maternity and Women Hospital, Thapathali, Kathmandu 44600, Nepal

Anesthesiologist

Downloads

Published

2020-01-20

How to Cite

K.C., K. K., Shrestha, A. B., & Shrestha, S. (2020). Fixed-dose versus height and weight-adjusted dose of intrathecal 0.5% hyperbaric bupivacaine in elective cesarean section: A comparative study. Journal of Society of Anesthesiologists of Nepal, 6(2), e217. https://doi.org/10.3126/jsan.v6i2.27327

Issue

Section

Original Articles