Abstract
Background
Spinal anesthesia using hyperbaric bupivacaine is the technique of choice for elective cesarean sections; however, the optimal concentration that ensures adequate anesthesia with minimal hemodynamic disturbance remains controversial. Higher concentrations may increase adverse effects without providing additional clinical benefit.
Objective
To compare the effectiveness, hemodynamic stability, and adverse effects of intrathecal hyperbaric bupivacaine 0.5% and 0.75% in patients undergoing elective cesarean section.
Methods
A retrospective observational comparative study was conducted on 80 parturients (ASA II, aged 20–40 years) undergoing elective cesarean section. Patients were equally divided into two groups: Group A received 12 mg of 0.5% hyperbaric bupivacaine, while Group B received 12 mg of 0.75% hyperbaric bupivacaine intrathecally. Hemodynamic parameters including systolic blood pressure and heart rate were recorded at baseline and at 15, 30, 45, and 60 minutes after spinal anesthesia. Sensory block level, onset of motor block, incidence of nausea and vomiting, patient satisfaction, and requirement for rescue vasopressors were also evaluated. Statistical analysis was performed using SPSS version 30.
Results
Both groups demonstrated comparable baseline demographic characteristics. No statistically significant difference was observed in systolic blood pressure or heart rate between the two groups throughout the observation period (p > 0.05). A higher proportion of patients in Group A achieved a T4 sensory block level compared to Group B (85% vs. 65%, p < 0.05). The incidence of nausea and vomiting was significantly lower in Group A (12.5%) than in Group B (40%, p < 0.01). Patient satisfaction was higher in the 0.5% group, and fewer patients required rescue vasopressor therapy compared to the 0.75% group.
Conclusion
Intrathecally hyperbaric bupivacaine 0.5% provides comparable hemodynamic stability with superior sensory block characteristics, fewer adverse effects, and greater patient satisfaction compared to 0.75% hyperbaric bupivacaine. The lower concentration appears to be a safer and more effective option for spinal anesthesia in elective cesarean sections.