Spinal Anaesthesia With Low-dose Bupivacaine in Marginally Hyperbaric Solutions for Caesarean Section: A Randomized-Controlled Trial

Abstract

(Eur J Anaesthesiol. 2015;32(7):493–498) Studies involving spinal anesthesia in nonobstetric situations have demonstrated that marginally hyperbaric bupivacaine solutions (containing ≤0.8% glucose but still denser than cerebrospinal fluid) produce a more consistent block albeit a lower sensory level than the conventional hyperbaric solution containing 8% glucose. The marginally hyperbaric solution has also been found to have a lower rate of hypotension in the nonobstetric setting. However, the efficacy of spinal anesthesia with marginally hyperbaric low-dose bupivacaine has not been studied during cesarean section (CS). This randomized, controlled trial compared the efficacy of 3 different marginally hyperbaric solutions of low-dose (7.2 mg) bupivacaine with that of the conventional hyperbaric solution in women undergoing elective CS The investigators hypothesized that the marginally hyperbaric low-dose bupivacaine solutions would be associated with a reduced cephalad spread and a reduced incidence of side effects compared with the conventional hyperbaric solution.