Epidural Volume Extension and Intrathecal Use of Local Anesthetics in Cesarean Sections

Assessment of Sensory and Motor Block After Intrathecal Administration of Bupivacaine, Ropivacaine and Levo-bupivacaine Combined With Small Doses of Fentanyl, Followed by Administration of Normal Saline Epidurally:a Clinical Trial in Parturients Scheduled for C-section

Intrathecal (i.t.) administration of isobaric bupivacaine, ropivacaine and levobupivacaine with addition of fentanyl for c-section either combined or not with administration of 10 ml of N/S 0,9% epidurally, in order to extent epidural space.Sensory and motor block profile, haemodynamics and side effects were assessed.

Parturients scheduled for elective caesarean section are randomly allocated to 6 groups: they receive double-blindly intrathecal isobaric bupivacaine 10 mg ( Group B), ropivacaine 15mg (Group R) , levobupivacaine 10mg (Group L) combined with 10 μg fentanyl and followed by epidural administration of 10 ml of N/S 0,9% respectively, and isobaric bupivacaine 10 mg ( Group BupivacaineF), ropivacaine 15mg (Group RopivacaineF) , and levobupivacaine 10mg (Group LevobupivacaineF) combined with 10 μg fentanyl without epidural administration of 10 ml of N/S 0,9%. Clinical endpoints are the sensory and motor block profile, haemodynamics (arterial pressure, heart rate) and side effects.

Inclusion Criteria:

• Elective cesarean section
• ASA I-II

Exclusion Criteria:

• complicated pregnancy (i.e preeclampsia, eclampsia,arterial hypertension, diabetes mellitus)
• abnormal fetal heart rate at the time of admission
• body mass index > 35 kg/m2
• height <150cm and >185 cm
• age <18 yrs and >40 yrs
• patients with contraindication to spinal anaesthesia( i.e anticoagulants)
• ASA >III
• intraoperative excessive bleeding
• patients with previous psychiatric diseases