P.32 Intrathecal anaesthetic drug dosing strategies for repair of perineal tears: An evaluation of current practice

Abstract

Introduction: Spinal anaesthesia is the method of choice for obstetric procedures due to avoidance of the additional risks posed by general anaesthesia to the obstetric population. [1] Bloom SL, Spong CY, Weiner SJ, et al. Complications of anesthesia for cesarean delivery. Obstet Gynecol 2005;106:281–7. Google Scholar Excessive intrathecal dosage during neuraxial blockade is associated with greater incidence of side effects, [2] Van de Velde M, Van Schoubroeck D, Jani J, et al. Combined spinal- epidural anesthesia for cesarean delivery: dose-dependent effects of hyperbaric bupivacaine on maternal hemodynamics. Anesth Analg 2006;103:187–90. Google Scholar including hypotension, nausea and vomiting and an increased length of time to recovery from anaesthesia [3] Nair GS, Abrishami A, Lermitte J, Chung F. Systematic review of spinal anaesthesia using bupivacaine for ambulatory knee arthroscopy. Br J Anaesth 2009:307–15. Google Scholar that may adversely affect breastfeeding, bonding with the child and overall maternal satisfaction. To date there is no literature supporting a standardised intrathecal dose for perineal tear repair and we sought to investigate the range of current practice.