P.18 The bupivacaine guessing game: Variance in spinal local anaesthetic volume for preterm caesarean delivery

Abstract

Introduction: Intrathecal spread of local anaesthetic (LA) increases in pregnancy. Enhanced neural sensitivity and reduced CSF volume due to venous engorgement from the gravid uterus, are contributary. 1 Fassoulaki A, Gatzou V, Petropoulos G, Siafaka I. Spread of subarachnoid block, intraoperative local anaesthetic requirements and postoperative analgesic requirements in Caesarean section and total abdominal hysterectomy. Br J Anaesth 2004;93:678–82. Google Scholar , 2 Adesope AE, Einhorn AM, Olufolabi AJ et al. The impact of gestational age and fetal weight on the risk of failure of spinal anesthesia for caesarean delivery. Int J Obstet Anesth 2016;26:8-14 Google Scholar Effects are reduced in preterm patients, however the magnitude of reduction of LA spread is unpredictable. This is an independent risk factor for block failure. [2] Adesope AE, Einhorn AM, Olufolabi AJ et al. The impact of gestational age and fetal weight on the risk of failure of spinal anesthesia for caesarean delivery. Int J Obstet Anesth 2016;26:8-14 Google Scholar We analysed variation in LA dosing for preterm caesarean delivery.