Abstract
Introduction and Objectives: Caesarean sections generally done under subarachnoid block using 0.5% hyperbaric bupivacaine as the local anaesthetic of choice. As most caesarean sections are of short duration, we decided to study whether 1% 2-chloroprocaine would be suitable alternative to bupivacaine with primary outcome being duration of sensory blockade in elective lower segment caesarean sections. Materials and Methods: In this prospective study, 60 pregnant females belonging to ASA status 1 and 2, posted for elective lower segment caesarean section were equally randomized into two groups. The first group received 1% chloroprocaine 25 mg (2.5 ml, Group CP) and second group received 0.5% hyperbaric bupivacaine 10 mg (2.0 ml, Group B), intrathecally. We measured the level of sensory and motor blockade, duration of sensory blockade and side effects. Results: Mean duration of sensory blockade was 61.83 23.54 minutes for group CP, which is significantly shorter than group B which had 174.67 41.17 minutes (p Value clinically significant incidences of hypotension (53.33% Vs 30%) compared to group CP. Conclusion: Intrathecal low dose 1 % chloroprocaine is a safe and suitable alternative to low dose 0.5% hyperbaric bupivacaine for an uncomplicated elective lower segment caesarean section. Keywords: 1% 2-Chloroprocaine 0.5% Hyperbaric bupivacaine, Subarachnoid block, Lower segment caesarean section.
Highlights
Introduction and ObjectivesCaesarean sections generally done under subarachnoid block using 0.5% hyperbaric bupivacaine as the local anaesthetic of choice
Most of the uncomplicated elective lower segment caesarean section (LSCS) procedures are done mainly using subarachnoid block (SAB) and are of short duration. 0.5% hyperbaric bupivacaine is a standard and established long acting local anaesthetic used in almost all the spinal anaesthesia procedures a days.[1]
Even though shorter acting agents such as lignocaine have been found to provide an acceptable profile for outpatient spinal anesthesia when used in conventional doses, but the use of lignocaine has declined due to concerns about the risk of transient neurological symptoms (TNS). 7,8 and most anesthesiologists have abandoned its use. 7,8 mepivacaine has been associated with transient neurological symptoms. 8
Summary
Introduction and ObjectivesCaesarean sections generally done under subarachnoid block using 0.5% hyperbaric bupivacaine as the local anaesthetic of choice. Conclusion: Intrathecal low dose 1 % chloroprocaine is a safe and suitable alternative to low dose 0.5% hyperbaric bupivacaine for an uncomplicated elective lower segment caesarean section. Most of the uncomplicated elective lower segment caesarean section (LSCS) procedures are done mainly using subarachnoid block (SAB) and are of short duration. There is little information on the clinical characteristics of bupivacaine compared with CP when employed in low intrathecal doses in patients undergoing elective LSCS. 9 ; we compared the anesthetic characteristics of low intrathecal doses of 0.5% hyperbaric bupivacaine and 1% 2-chloroprocaine to determine if CP would be a suitable alternative for bupivacaine in patients undergoing elective LSCS
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