TO STUDY THE HEMODYNAMIC STABILITY BETWEEN 0.5% HYPERBARIC LEVOBUPIVACAINE AND 0.5% HYPERBARIC BUPIVACAINE FOR SPINAL ANESTHESIA IN CESAREAN SECTION.

Abstract

Background: Spinal anesthesia is  most commonly used for both elective and emergency cesarean section. The aim of this study was to compare the hemodynamic effects of intrathecal 0.5% hyperbaric levobupivacaine with 0.5% hyperbaric bupivacaine in spinal anaesthesia for lower segment caesarean section.

 Materials and Methods

 After Institutional Ethical Committee approval, 60 patients of American Society of Anesthesiologists I-II and age between 18-40 years  after obtaining written informed consent to receive  spinal anesthesia for cesarean section were randomized into two groups: Group B  (0.5% hyperbaric bupivacaine 10 mg in L _3-4 intrathecal space),and Group L (0.5% hyperbaric levobupivacaine 10 mg in L _3-4 intrathecal space). The hemodynamic changes including heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure were recorded for every 1 min for 3 consecutive min, then every 5 min  to 15 min, and then every 15 min interval throughout the surgery.Hypotension (systolic blood pressure <100 mmHg or fall >20% from baseline) was managed with injection mephentermine 3 mg IV in incremental doses.Bradycardia is defined as HR<50/min and treated with atropine 0.6 mg IV. Statistical analysis was performed using the SPSS version 20 software windows. A P < 0.05 was considered significant.

 Results

 The sensory block levels required for cesarean section were achieved in both groups and it was observed that heart rate, SBP, DBP and MAP were more stable in Group L and the requirement for Injection mephentermine was more in Group B.

Conclusion:

Hyperbaric Levobupivacaine 10 mg used in lower segment cesarean section provided more stable hemodynamics as compaired to 10mg hyperbaric bupivacaine    when given in L _3-4 space.