The effects of 7 mg levobupivacaineon maternal hemodynamics with side effects in combined spinal- epidural anaesthesia for caesarean section
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Background: It has been reported that 10-15 mg local anaesthetic is enough for cesarean sections. Reduced doses of levobupivacaine may decrease the incidence of associated complications e.g. hypotension, nausea, vomiting and the vasopressor use. The primary objective of this study was to compare 7 mg and 10 mg doses of intrathecal levobupivacaine on maternal hemodynamics. The secondary objective was to determine the differences in sensory block, the vasopressor use, associated side effects and a need for additional analgesics between the groups. Methodology: Following ethical committee approval, thirty three women presenting for elective cesarean delivery were randomly assigned to one of the 2 groups. Group-7 received 7 mg intrathecal levobupivacaine and Group-10 received 10 mg. Women in both groups received 10 ml/kg crystalloids intravenously, at the time of initiation of combined spinal – epidural anesthesia. Surgery began when a sensory level was at T4. Maternal hemodynamics and sensorimotor levels were recorded at regular intervals. Side effects, additional analgesics and the vasopressor use were documented. Results: No difference was observed in the incidence of hypotension ( p:0.482), bradycardia (p:1.00) or nausea and vomiting (p:0.448) between two groups. Incidence of additional analgesic requirement and vasopressor requirement was also similar in both groups (p:0.383). Conclusion: Intrathecal levobupivacaine 10 mg and 7 mg yielded similar maternal hemodynamics, sensory block, side effects and additional analgesic requirement during cesarean delivery.