Abstract
(Anaesthesia. 2018;73:499–511) Bupivacaine is the most commonly used local anesthetic for cesarean delivery performed with spinal anesthesia. It is usually available in in both isobaric and hyperbaric formulations. Although both formulations have been widely used, the difference in density between the 2 may result in differing diffusion patterns and distribution after intrathecal injection. While some studies have suggested that hyperbaric and isobaric bupivacaine differ in some block characteristics, such as motor blockade and duration of action, the superiority of one formulation over the other has not been determined. Therefore, this Cochrane systematic review and meta-analysis was performed to determine the efficacy and safety of hyperbaric bupivacaine compared with isobaric bupivacaine for spinal anesthesia in women undergoing elective cesarean delivery.
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