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Low-dose spinal anesthesia in cesarean section: a narrative review
Ahmet Pınarbaşı1, Başak Altıparmak2, Tolga Karaçay3
1Anesthesiology and Reanimation Clinic, Odak Hospital, Denizli, 20100, Turkey. ahmt.pinarbasi92@gmail.com.
Low-dose spinal anesthesia (LDSA) for cesarean delivery may reduce hypotension and nausea. However, doses must be carefully chosen to avoid incomplete anesthesia, making LDSA a context-specific option.
Area of Science:
- Anesthesiology
- Obstetric Anesthesia
Background:
- Spinal anesthesia is standard for cesarean delivery.
- Conventional doses of hyperbaric bupivacaine can cause hypotension and delayed recovery.
Purpose of the Study:
- To investigate low-dose spinal anesthesia (LDSA) as a strategy to mitigate adverse effects of spinal anesthesia.
- To evaluate the benefits and limitations of LDSA in obstetric anesthesia.
Main Methods:
- Review of current evidence on LDSA (≤8 mg hyperbaric bupivacaine) for cesarean delivery.
- Analysis of hemodynamic stability, intraoperative nausea, neonatal outcomes, and block efficacy.
Main Results:
- LDSA can attenuate hemodynamic fluctuations and reduce nausea without compromising neonatal outcomes.
- Excessively low doses risk incomplete block and conversion to general anesthesia.
- LDSA may benefit patients with cardiovascular compromise.
Conclusions:
- LDSA is a context-specific alternative in obstetric anesthesia.
- Benefits and limitations must be weighed against standard hypotension management strategies.
- Routine dose reduction for all patients is not currently supported by data.
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