Haemodynamic Parameters and Block Characteristics between Fixed Volume and Adjusted Volume of Intrathecal Hyperbaric Bupivacaine In Elective Caesarean Section

Maharjan SK**, Shrestha PR*,


INTRODUCTION: Hypotension after induction of spinal anaesthesia may compromise uteroplacental
circulation in parturients. To decrease such incidence among Nepalese parturients along with simultaneous
adequate block effect, fixed volume and calculated volume of intrathecal Bupivacaine were compared.
METHOD: Sixty singleton term parturients undergoing elective caesarean section under spinal anaesthesia
were enrolled in this prospective; single blind randomized controlled study conducted in Kathmandu Medical
College Teaching Hospital. In fixed group (FD), fixed volume of 2.2 ml 0.5% hyperbaric Bupivacaine was given.
In adjusted group (AD), volume of 0.5% hyperbaric Bupivacaine was calculated according to height and weight
from the Harten’s chart. The haemodynamic parameters, onset of grade IV motor block according to modified
Bromage scale and onset of sensory block at T6 level of both groups were studied and compared.
RESULT: The haemodynamic parameters throughout the surgery were similar in both groups, but the numbers
of hypotensive episodes were higher in FD (63.33%) than that in AD (50%). However, this was statistically
insignificant (p-value = 0.29). The time of achieving sensory block at T6 level and complete motor block were
statistically insignificant (p-value = 0.61 and 0.55 respectively).
CONCLUSION: There were no significant differences in the hemodynamic parameters and block characteristics
adjusting the volume of intrathecal 0.5% heavy Bupivacaine according to Harten’s chart, as compared to
administering the fixed volume of 2.2 ml of 0.5% hyperbaric Bupivacaine for spinal anaesthesia in elective
caesarean section.

Full Text: