The Outcome of Low Dose of 0.5% Bupivacaine in Spinal Anesthesia during Lower Segment Cesarean Section (LUCS)

Abstract

Background: The spinal anesthesia in a lower segment cesarean section continues to provide a challenge to the anesthetist in the form of either severe hypotension caused by a big bupivacaine dose or insufficient appropriate anesthesia level conditions caused by a little bupivacaine dose. Objective: In this study our main goal is to evaluate the efficacy of low dose of 0.5% Bupivacaine in spinal anesthesia during lower segment cesarean section. Method: This cross sectional comparative study was carried out at tertiary medical College from January 2021 to January 2021. Where a total of 100 pregnant women were included in the study? Patients, who agreed to the study, were randomized divided into two groups: Group A patients who received an intrathecal injection of 3 mL of bupivacaine 0.5%, n=50 and Group B patients who received an intrathecal injection of 2.5 mL of bupivacaine 0.5%, n=50. The method of randomization was by coin tossing. Results: During the study, majority were belonging to 26-33 years age group, 60% and 70% were multiparous. The satisfactory surgical sensory level was achieved in all cases in both groups with the following distribution. However, Only 19% cases in Group A were indicated to have ephedrine, whereas 89% in Group B were indicated to support their blood pressure with ephedrine. There were no differences between the two groups regarding the fluid intake (894 ± 126mL) in Group A versus 720 ± 212 mL in Group C with P > 0.05). Neonatal Apgar score was 9 in the first 1 min and increased to 10 at 5 min. In addition, group A nausea and vomiting cases seen in 19% cases whereas in group B it was 23%. Conclusion: We can say that, unlike low dose, a large dose of hyperbaric bupivacaine in the spinal anesthetic for a lower segment cesarean section will result in excellent surgical circumstances with little hypotension. Further study is needed for better outcome.