Subarachnoid bupivacaine 0.5% for caesarean section

Area of Science:

• Anesthesiology
• Obstetrics

Background:

• Spinal analgesia is crucial for Cesarean sections.
• Achieving symmetrical and adequate sensory block spread is essential for effective pain management during surgery.

Purpose of the Study:

• To describe a technique using 0.5% bupivacaine for spinal analgesia in awake Cesarean section patients.
• To evaluate the impact of patient positioning and needle technique on block characteristics.

Main Methods:

• A series of 52 patients undergoing awake Cesarean section received spinal analgesia with 0.5% bupivacaine.
• A needle-through-needle technique was employed, with patient repositioning from left to right lateral immediately post-injection.
• Optimal bupivacaine volume was determined to be 2.25-2.75 ml.

Main Results:

• Patient repositioning significantly improved the symmetry and cephalic spread of the analgesic block.
• The mean time to maximal spread of analgesia was 17.5 minutes.
• The mean time to first postoperative analgesic was 163.5 minutes.

Conclusions:

• Patient repositioning is a key maneuver to optimize spinal block characteristics for Cesarean sections.
• The needle-through-needle technique with specific bupivacaine volumes provides effective analgesia.
• Hypotension and unpredictable spread remain potential disadvantages requiring careful management.