https://www.nepjol.info/index.php/JSAN/issue/feed Journal of Society of Anesthesiologists of Nepal 2020-01-21T15:05:10+00:00 Dr Apurb Sharma and Dr Achyut Sharma jsan2070@gmail.com Open Journal Systems <p>The official journal of the Society of Anesthesiologists of Nepal (SAN). Also available at <a title="JSAN" href="http://www.jsan.org.np" target="_blank" rel="noopener">http://www.jsan.org.np/jsan/index.php/jsan</a></p> https://www.nepjol.info/index.php/JSAN/article/view/27327 Fixed-dose versus height and weight-adjusted dose of intrathecal 0.5% hyperbaric bupivacaine in elective cesarean section: A comparative study 2020-01-21T15:05:09+00:00 Kiran Kumar K.C. jsan2070@gmail.com Amir Babu Shrestha jsan2070@gmail.com Sangeeta Shrestha jsan2070@gmail.com <p><strong>Background: </strong>Spinal anesthesia is the preferred anesthetic technique for cesarean deliveries. But there is a dosage</p> <p>dilemma regarding block to the desired level and preventing hypotension. We aim to study effects of fixed dose</p> <p>with height and weight-adjusted dose of intrathecal 0.5% hyperbaric bupivacaine during elective cesarean section.</p> <p><strong>Methods: </strong>Eighty-eight singleton term parturient was enrolled and divided into two groups, Group FD (Fixed Dose)</p> <p>and CD (Calculated Dose) in this Prospective, double-blind, randomized controlled trial. Group FD received 2.2 ml</p> <p>and CD received a calculated dose from Harten chart. Hemodynamic changes, onset time to sensory block T6,</p> <p>Maximum block in 20 minutes, and adverse effects were compared.</p> <p><strong>Results: </strong>There was a significant reduction in median drug dosage 11mg in FD versus 9 mg in CD group. The</p> <p>decrease in the MAP was less in group CD (14.5±2.98) mmHg compared to (17.6±4.66) mmHg in group FD (P=</p> <p>0.03).The median onset time of spinal block to T6 in Group FD 2 minutes with IQR (2-3) was faster than Group CD,</p> <p>4 minutes with IQR (3-5). The spinal block extended above T4 in the larger number of parturient 23(52 %) in Group</p> <p>FD than in three (6.8%) in Group CD(p&lt;0.05). Significantly larger number 20(45.45 %) in Group FD developed</p> <p>Hypotension than seven (15.9 %) in Group CD. Bradycardia and vomiting were also found in Group FD.</p> <p><strong>Conclusions: </strong>This calculated dose provided the desired level of the spinal block and also restricted spinal block</p> <p>level with a distinct advantage of less hypotension.</p> 2020-01-20T07:59:20+00:00 ##submission.copyrightStatement##