Subarachnoid Administration of Levobupivacaine for Cesarean Section

Intrathecal Plain Bupivacaine, Ropivacaine and Levo-bupivacaine With or Without Fentanyl for Elective c Section.

The purpose of the investigators study is to compare the clinical effects and side-effects of these three local anaesthetics as sole agents or with the supplementation with fentanyl for c-section, especially when administered in doses achieving approximately an ED 50.

Intrathecal (i.t.) administration of isobaric bupivacaine, ropivacaine and levobupivacaine with or without addition of fentanyl for c-section do not exist to date .

Parturients scheduled for elective caesarean section will be allocated to receive double-blindly i.t. isobaric bupivacaine 10 mg, ropivacaine 15mg , levobupivacaine 10mg or the same local anaesthetics with 10 μg fentanyl respectively. Sensory block (pin prick test) and motor block (Bromage scale) profile, intraoperative and postoperative analgesia, haemodynamics and side effects will be assessed.

Inclusion Criteria:

• Parturients scheduled for elective c section
• Stillborn
• Normal cardiotocogram

Exclusion Criteria:

• BMI>35kg/m2
• Height <150cm or >185cm
• Age (<18, >40)
• ASA > II
• Multiple gestation
• Pregnancy complications (eclampsia, GDP, placenta previa, >2 previous c section)
• Contraindication to spinal anaesthesia
• Failure to educate the patient, language barrier
• Patient preferred GA