SPINAL-ANESTHESIA USING HYPERBARIC 0.75-PERCENT VERSUS HYPERBARIC 1-PERCENT BUPIVACAINE FOR CESAREAN-SECTION

Although 0.75% hyperbaric bupivacaine is commonly administered to prov ide spinal anesthesia for cesarean section in the United States, in so me countries, only the 1% hyperbaric solution of spinal bupivacaine is available. The aim of this study was to compare 0.75% with 1% hyperba ric spinal bupivacaine for cesarean section. Ln this prospective study , 50 patients undergoing elective cesarean section were randomized to receive a spinal anesthetic with either 1.5 mt of 0.75% bupivacaine (n = 25) or 1.125 mi, of 1% bupivacaine (n = 25). There were no statisti cally significant differences in patient demographics, time to onset o f block, or intraoperative pain. All patients had a successful block f or surgery. The time from injection of the spinal anesthetic to first request for pain medication in the postanesthesia care unit was longer in the women who received 0.75% bupivacaine (4.3 vs 3 h; P < 0.05). S ix women (24%) who received 1% bupivacaine versus one woman (4%) who r eceived 0.75% bupivacaine complained of postoperative backache (P < 0. 05). Ln addition, postdural puncture headache occurred in four women, all of whom received 1% bupivacaine (P = 0.04). In conclusion, our dat a suggest that 0.75% bupivacaine results in fewer postoperative proble ms and offers several significant benefits compared with the 1% concen tration Implications: Although 0.75% bupivacaine is usually used to pr ovide spinal anesthesia for cesarean section in the United States, a m ore concentrated solution is popular in Europe. In this study, we comp ared 0.75% bupivacaine with 1% bupivacaine when administered for cesar ean section and found that the 0.75% solution offers several significa nt benefits.