High-volume Spinal Anesthesia with Bupivacaine 0.125% for Cesarean Section

Zundert, A.A. van; Wolf, André M. De; Vaes, L.; Soetens, M.

doi:10.1097/00000542-198812000-00041

Cited by 34 publications

(12 citation statements)

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“…However, one retrospective review has described the use of CSE in labor in a community hospital. 11,12 The improvement in first-stage analgesia from a CSE technique may be the result of more accurate placement of the epidural catheter into the posterior epidural space after the confirmation provided by cerebrospinal fluid flow during the spinal component. Compared with reported rates of epidural catheter failure during labor, they found their CSE technique to have fewer analgesic failures.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Comparison of Epidural Analgesia and Combined Spinal-Epidural Analgesia in a Private Practice Setting

Gambling

Berkowitz

Farrell³

et al. 2013

Anesthesia &Amp; Analgesia

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Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Comparison of Epidural Analgesia and Combined Spinal-Epidural Analgesia in a Private Practice Setting

Gambling

Berkowitz

Farrell³

et al. 2013

Anesthesia &Amp; Analgesia

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“…Subarachnoid bupivacaine 0.125% 10 ml with adrenaline has recently been investigated as an agent for spinal caesarean section. 9 A sensory level of T9 was achieved within two minutes, mean maximum level being T2 (range C5-T5). Profound motor block of the lower extremities developed rapidly, but no patient experienced respiratory difficulty.…”

Section: Discussionmentioning

confidence: 90%

Inadvertent Spinal Anaesthesia with 0.125% Bupivacaine and Fentanyl during Labour

Paech

1990

Anaesthesia and Intensive Care

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Inadvertent subarachnoid administration of epidural solution is a well-recognised, rare, but potentially life-threatening complication of obstetric analgesia. The recent introduction of combination low-dose bupivacaine and lipophilic opioid for epidural analgesia during labour creates the potential for both unintentional spinal anaesthesia and severe opioid-induced respiratory depression, should this complication occur. This case report describes the unrecognised subarachnoid injection of 0.125% bupivacaine with fentanyl 100 mcg, and a subsequent 'total spinal' after a second larger bolus dose of bupivacaine alone, in an obstetric patient having epidural analgesia in labour. CASE REPORT A 20-year-old, 84 kg primiparous woman was induced for post-maturity. Following two doses of intramuscular pethidine 100 mg, which did not provide adequate analgesia, she requested epidural analgesia. Cervical dilatation at this time was 3 cm. The anaesthetic registrar experienced considerable difficulty in siting an epidural catheter, making several attempts with the woman positioned both lateral and sitting. Eventually the epidural space was identified at a depth of 5 cm in the L2-3 interspace and a 16-gauge three side-holed catheter inserted 4 cm into the epidural space. After negative aspiration, a bolus dose of 12.5 mg of bupivacaine (0.125% plain bupivacaine 10 ml) combined with fentanyl 100 mcg, was administered. Rapid pain relief was obtained and

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“…As bupivacaine 0.125% is used predominantly in labour pain relief, this study was repeated in twenty obstetric patients presenting for caesarean section. 2 Sensory block was rapid with the maximum sensory level at T2 (range C5 to T5). This contrasted greatly with a previous study in which the same dose of bupivacaine administered as a 0.5% solution resulted in several blocks that extended to Cl /C2.…”

Section: Discussionmentioning

confidence: 96%

“…The effects of subarachnoid administration were then studied by simulating inadvertent spinal administration in patients presenting for urologica1 surgery and later in twenty patients presenting for caesarean section. 2 Intrathecal administration resulted in a sensory block which was rapid and reliable but at times too high. Motor blockade was complete and patients were haemodynamically stable.…”

mentioning

confidence: 99%

High-Volume Spinal Anaesthesia. A Dose-Response Study of Bupivacaine 0.125%

Tay

Thomas

1992

Anaesth Intensive Care

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The clinical effects of high-volume spinal anaesthesia with bupivacaine 0.125% were studied in 30 patients presenting for postpartum sterilisation. Group A, Band C patients received 6, 8 and 10 ml of bupivacaine 0.125% respectively. Onset, duration and regression of sensory block and motor blockade, haemodynamic parameters and postoperative complications were studied. A sensory level ofT1O was reliably obtained in Group Band C but not in Group A. Similarly motor blockade was unreliable in Group A compared with Group B (P < 0.05) and Group C (P < 0.05). Two segment regression times were similar in all three groups. L 1 regression times were 47. 9, 94.3 and 99.0 minutes in Groups A, Band C respectively. The corresponding times for complete recovery of motor power were 120, 212.3 and 182. 7 minutes respectively (P < 0.01 when Group A compared to B and C). A significant incidence of high spinal anaesthesia occurred when 10 ml bupivacaine 0.125% was administered (P < 0.05 when compared with Group A). No patient experienced respiratory discomfort in spite of sensory levels of up to T1. Hypotension responded readily to intravenous fluids and small doses of ephedrine (three patients). Only one patient (Group A) developed a postdural puncture headache. In this study, high-volume spinal anaesthesia with bupivacaine 0.125% was found to be satisfactory for postpartum tuballigation. The optimal volume of bupivacaine 0.125% was 8 ml.

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High-volume Spinal Anesthesia with Bupivacaine 0.125% for Cesarean Section

Cited by 34 publications

References 0 publications

A Randomized Controlled Comparison of Epidural Analgesia and Combined Spinal-Epidural Analgesia in a Private Practice Setting

A Randomized Controlled Comparison of Epidural Analgesia and Combined Spinal-Epidural Analgesia in a Private Practice Setting

Inadvertent Spinal Anaesthesia with 0.125% Bupivacaine and Fentanyl during Labour

High-Volume Spinal Anaesthesia. A Dose-Response Study of Bupivacaine 0.125%

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