Journal of Society of Anesthesiologists of Nepal 2020-04-15T11:19:13+00:00 Dr Apurb Sharma and Dr Achyut Sharma Open Journal Systems <p>The official journal of the Society of Anesthesiologists of Nepal (SAN). Also available at <a title="JSAN" href="" target="_blank" rel="noopener"></a></p> Fixed-dose versus height and weight-adjusted dose of intrathecal 0.5% hyperbaric bupivacaine in elective cesarean section: A comparative study 2020-04-15T11:19:13+00:00 Kiran Kumar K.C. Amir Babu Shrestha Sangeeta Shrestha <p><strong>Background: </strong>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.</p> <p><strong>Methods: </strong>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.</p> <p><strong>Results: </strong>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&lt;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.</p> <p><strong>Conclusions: </strong>This calculated dose provided the desired level of the spinal block and also restricted spinal block level with a distinct advantage of less hypotension.</p> 2020-01-20T00:00:00+00:00 Copyright (c) 2020 Kiran Kumar K.C., Amir Babu Shrestha, Sangeeta Shrestha