Key result
Spinal dose requirements of intrathecal ropivacaine did not differ significantly between shorter and taller patients undergoing caesarean section (P = 0.886).
Why the study?
Does body height affect the dose requirement and safety of intrathecal ropivacaine in pregnant women undergoing caesarean section?
RCT (n=270)
Randomly assigned
Does body height affect the dose requirement and safety of intrathecal ropivacaine in pregnant women undergoing caesarean section?
p-value: p=0.886
Body height does not significantly alter the modest dose requirement for intrathecal ropivacaine in caesarean sections, but higher doses increase the risk of hypotension in shorter patients.
Height-based ropivacaine dosing adjustments are not supported by this cohort; leaves open confirmation in randomized caesarean trials.
BACKGROUND: values of intrathecal ropivacaine in taller and shorter patients, and thus investigate the hypothesis that the spinal dose requirement in shorter patients is lower than that in taller patients undergoing caesarean section. METHODS: In this study, 270 pregnant women were assigned to the taller (Group T) or shorter group (Group S) based on their heights. Subjects in both groups were further randomly assigned to one of nine subgroups based on the dosage of intrathecal isobaric ropivacaine to be administered (7, 8, 9, 10, 11, 12, 13, 14 or 15 mg respectively). RESULTS: values of ropivacaine were 9.24 mg and 13.36 mg in Group S, and 10.11 mg and 14.63 mg in Group T, with no inter-group difference (P = 0.886). There was a significant inter-group difference in the incidence of hypotension and the changes in mean arterial pressure after spinal anaesthesia using 15 mg ropivacaine. The dose of ephedrine administered in Group S was higher than that in Group T when 15 mg ropivacaine was administered (P = 0.031). CONCLUSION: The taller and shorter patients did not respond differently to modest intrathecal doses of ropivacaine. However, a larger dose of ropivacaine was associated with an increased incidence of hypotension in shorter patients compared to that in taller patients.
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She et al. (2017) conducted an RCT in Caesarean section (n=270). Intrathecal isobaric ropivacaine vs. Taller vs shorter patients was evaluated on Spinal dose requirement of ropivacaine (p=0.886). Spinal dose requirements of intrathecal ropivacaine did not differ significantly between shorter and taller patients undergoing caesarean section (P = 0.886).
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