Ewha Med J.  2012 Sep;35(2):83-88. 10.12771/emj.2012.35.2.83.

Effect of Injection Speed of Local Anesthetic on Hypotension during Spinal Anesthesia for Cesarean Section

• Kang YI
• Bang EC
• Shin DW
• Kweon DE
• Kim SY
• Lee HS
• Cho KS
• Lee SY

• KMID: 2283997
• DOI: http://doi.org/10.12771/emj.2012.35.2.83

Abstract

OBJECTIVES
Maternal hypotension is a common problem during cesarean section under spinal anesthesia. We evaluated the influence of injection speed of local anesthetic to subarachnoid space on maternal hypotension and level of sensory block.
METHODS
Bupivacaine (0.5%) 9 mg with fentanyl 10 microg was injected to subarachnoid space either quickly (during 20 seconds, 0.1 mL/sec, n=20) or slowly (during 100 seconds, 0.02 mL/sec, n=20) in parturients scheduled for elective cesarean section. The onset and level of sensory block was checked and heart rate and blood pressure was checked by 2.5 minutes during 20 minutes. Hypotension (systolic blood pressure <100 mmHg or <70% of baseline) was treated with ephedrine.
RESULTS
Hypotension occurred 70% of parturients with spinal anesthesia. Slow injection didn't influence on the onset and level of sensory block and didn't reduce the incidence of hypotension. But onset of hypotension was delayed.
CONCLUSION
Slow injection (during 100 seconds, 0.02 mL/sec) of local anesthetic delayed onset of hypotension and required less amount of ephedrine. Slow injection of local anesthetic was one of the effective methods for the cardiovascular stability during cesarean section under spinal anesthesia.

Keyword

Anesthesia; Cesarean section; Hypotension; Speed; Spinal injection

MeSH Terms

Anesthesia
Anesthesia, Spinal
Blood Pressure
Bupivacaine
Cesarean Section
Ephedrine
Female
Fentanyl
Heart Rate
Hypotension
Incidence
Injections, Spinal
Pregnancy
Subarachnoid Space
Bupivacaine
Ephedrine
Fentanyl

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