Key result
Large-dose bupivacaine with prolonged sitting reduces hypotension versus a small dose with immediate supine positioning.
Why the study?
Does a large dose of bupivacaine with prolonged sitting up reduce hypotension compared to a small dose with immediate supine position in patients undergoing elective cesarean section?
RCT (n=53)
Randomly divided
Does a large dose of bupivacaine with prolonged sitting up reduce hypotension compared to a small dose with immediate supine position in patients undergoing elective cesarean section?
p-value: p=<0.05
A larger dose of bupivacaine combined with prolonged sitting up reduces the incidence of hypotension while maintaining adequate anesthesia for cesarean sections.
Supports large-dose bupivacaine with sitting to lower hypotension risk in cesarean spinals; extends technique optimization evidence via RCT.
BACKGROUND AND AIM: The spinal anesthesia in a cesarean section is still presenting a challenge to the anesthetist in the form of either severe hypotension from large bupivacaine dose or insufficient satisfactory anesthesia level conditions as a result of small bupivacaine dose. In this study, we tried to solve this challenge by increasing the dose of bupivacaine to achieve a proper spinal level accompanied by prolonged sitting up to avoid hypotension. PATIENTS AND METHODS: We included 53 patients in this study whom were randomly divided into two groups, namely Group B and Group C. In Group B (25 patients), each patient received 3 mL of bupivacaine and left 5 min sitting up, whereas in Group C (28 patients), each patient received 2.5 mL of bupivacaine and was asked to lie supine immediately. Both groups were tested for hypotension, ephedrine dose, and sensory block level. RESULTS: < 0.05). The proper anesthesia level was achieved equally in both groups. CONCLUSIONS: Large dose 15 mg of bupivacaine with the prolonged sitting position will lead to fewer incidences of hypotension and proper anesthesia block.
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Ali et al. (2019) conducted an RCT in Elective cesarean section (n=53). Large dose bupivacaine with prolonged sitting vs. 2.5 mL of 0.5% bupivacaine and lie supine immediately was evaluated on Hypotension, ephedrine dose, and sensory block level (p=<0.05). Large dose (15 mg) bupivacaine with prolonged sitting position led to fewer incidences of hypotension compared to small dose with immediate supine position (P<0.05).
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