Key result
Lower-dose spinal bupivacaine increases ephedrine need for BP stabilization to ~89% vs higher doses.
Why the study?
Does a low dose (2.5 mL) of 0.5% bupivacaine improve hemodynamic stability compared to a 3 mL dose in pregnant women undergoing lower segment cesarean section?
RCT (n=100)
Coin toss
No
Does a low dose (2.5 mL) of 0.5% bupivacaine improve hemodynamic stability compared to a 3 mL dose in pregnant women undergoing lower segment cesarean section?
Absolute Event Rate: 89% vs 19%
Contrary to expectations, a lower dose of intrathecal bupivacaine (2.5 mL) during cesarean section was associated with a significantly higher requirement for ephedrine to treat hypotension compared to a 3 mL dose.
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Caution against 2.5 mL bupivacaine for cesarean spinal anesthesia; challenges expectations that lower doses improve hemodynamic stability.
Abdullah-Hel-Baki et al. (2023) conducted an RCT in Lower segment cesarean section (n=100). Bupivacaine 0.5% vs. Bupivacaine 0.5% 3 mL was evaluated on Need for ephedrine to stabilize blood pressure. A low dose of 2.5 mL of 0.5% bupivacaine for spinal anesthesia during cesarean section increased the need for ephedrine to stabilize blood pressure compared to a 3 mL dose (89% vs 19%).
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