Extradural Bupivacaine or Lignocaine Anaesthesia for Elective Caesarean Section

Abstract

Extradural anesthesia was induced in 64 gravidae who had selected this method for their elective cesarean section. Preoperative preparation included overnight fasting and ranitidine by mouth. Prehydration was achieved with one liter of Ringer's lactate solution during the 15 min before the extradural catheter was inserted at the L2–3 interspace. The volume of the first injection was related to the woman's height: women less than or equal to 1.52 m received 10 ml; those 1.52 −1.71 m received 13 ml; those greater than 1.71 m received 17 ml. Injections were performed in either the sitting or the lateral position. Bupivacaine 0.5% was administered in the sitting position to 16 women and in the lateral position to 14. Lidocaine 2% with epinephrine 1:200,000 was given in the sitting position to 18 women and in the lateral to 16. The sitting position was maintained for 10 min unless hypotension or dizziness developed. All subsequent doses were injected in the lateral position with left tilt of 10–15°. Hypotension was denned as a fall in arterial pressure of 25% or greater and was treated with ephedrine, 6 mg.