Effect of Site of Injection on Spread of Spinal Anaesthesia with Hyperbaric Bupivacaine

Abstract

Introduction:Spinal anaesthesia has its own unique place in modern anaesthetic practice. It also has gained popularity for obstetrics cases. Regional anaesthesia is associated with less maternal morbidity and mortality than general anaesthesia which may be largely due to reduced failed intubations and pulmonary aspiration. Spinal anaesthesia allow a mother to remain awake and experience the birth of her child. One important advantage like other regional technique is patient ability to participate in the whole procedure realizing what is going on and even to co-operate when necessary. It helps patient to get rid of one of the biggest concern of fear of not waking up after the surgery.The profile of spinal anaesthesia after subarachnoid administration of hyperbaric solutions changes with increasing ages 1 . Pregnancy is known to cause higher cephalad spread of analgesia 2,3 . Age and level of anaesthesia appear to be the main factors associated with the development of hypotension during spinal anaesthesia 4 .The degree of arterial hypotension correlate well with the level of sympathetic block which is 2-4 segment higher than level of anaesthesia. The predictibility of the extent and duration of sensory block has been noted by many authors. Factors thought to influence intrathecal spread are total dose 6 , baricity 9 7− , volume The purpose of our study was to compare the effects of 2 ml ( same volume) of 0.5% hyperbaric bupivacaine (same dose) at the site of L 2-3, L 3-4 and L 4-5 intervertebral space in lower uterine caesarean section in sitting position.We hypothesized that induction of spinal anaesthesia at L2-3 intervertebral space produce faster spread of anaesthesia and analgesia Materials & Methods:Ninety ASA (American society of Anaesthesiologist) physical status I & II patients scheduled for elective Caesarean section gave their written informed consent and were included in the study were randomly allocated Effect of Site of Injection on Spread of Spinal Anaesthesia with Hyperbaric Bupivacaine