Does 10mg versus 12.5mg of 0.5% hyperbaric bupivacaine influence the incidence of epigastric discomfort encountered during caesarean section under spinal anesthesia?

Abstract

Objective: To determine effect of two different volumes of 0.5 % hyperbaric bupivacaine in relation to epigastric discomfort during Cesarean section under spinal anaesthesia.

Study design: Randomized double blind study.

Place and Duration of study: Department of anaesthesiology, Combined Military Hospital Lahore over period of twelve months from June 2020 to May 2021.

Methodology: A total of 168 women presenting for elective Cesarean section were divided in two equal groups. In group A, 2 milliliters of hyperbaric 0.5% bupivacaine was given in intrathecal space while in group B, 2.5 milliliters of hyperbaric 0.5% bupivacaine was given after standard volume loading. Presence or absence of epigastric/visceral pain was observed. Mean arterial pressure was also recorded at 1, 5, 10, 20 and 40 minutes.   

Results: Demographic data including age, body mass index and American society of anesthesiology status was comparable in both groups. Hypotension was seen in 44 (52.38%) in group A whereas it was seen in 52 (61.9%) in group B. This difference was insignificant with p-value of 0.212. In group A, 22 (26.19%) patients complained of epigastric discomfort, while in group B, 12 (14.29%) patients complained of epigastric discomfort. Though fewer patients in group B suffered epigastric discomfort but this difference was statistically insignificant with a p-value of 0.055.

Conclusion: There was no statistically significant difference between 2 ml and 2.5 ml 0.5% hyperbaric bupivacaine in terms of frequency of visceral pain.