INFLUENCE OF MATERNAL POSITIONING, SITTING VS LATERAL FOR SPINAL ANAESTHESIA WITH 0.5% ISOBARIC LEVOBUPIVACAINE IN ELECTIVE CAESAREAN SECTIONS – A PROSPECTIVE, RANDOMIZED COMPARATIVE STUDY

Abstract

Introduction: Spinal anaesthesia is a commonly employed anesthetic technique for caesarean sections.
Levobupivacaine is a new long acting amide, local anesthetic. Only few studies have investigated spinal
anaesthesia using plain levobupivacaine in obstetrics and the effect of posture on spinal anaesthesia in
parturients. Objective: The objective of our study was to find out the effect of position sitting vs lateral
using Isobaric 0.5% levobupivacaine 2ml on spinal anaesthesia in parturients undergoing caesarean
section on sensory and motor block. Methodology: Fifty American Society of Anesthesiologists physical
status class II parturients scheduled for elective lower segment caesarean section under subarachnoid
block were randomly allocated into two groups (n = 25), Group S – Isobaric Levobupivacaine 0.5% 2ml
administered in sitting posture and Group L – Isobaric Levobupivacaine 0.5% 2ml administered in lateral
posture. The sensory and motor block characteristics were recorded. Results: In our study, we observed
that the mean time for onset of sensory block at T 10 level in group S was 2.4 ± 0.53 minutes while 2.9 ±
0.74 minutes in Group L (p value = 0.0071). In our study the highest level of sensory block achieved was
T4 and T5 in sitting and lateral group respectively and is statistically significant. The time for maximum
sensory block in sitting group was 3.82±1.10 minutes and in Lateral group was 4.27±0.91 minutes. The
Time for 2 segment regression was 81.80±18.54 minutes in Group S whereas 82.40±22.67 minutes Group
L. The time for onset of motor block was 2.28±0.39 minutes in Sitting Group whereas 2.26±0.36 min in
Lateral Group. The mean time to complete motor blockade was 3.38 ± 0.70 min in Group S and 3.87 ±
0.82 min in Group L. The duration of motor block was 193.88 ± 51.98 min and 191.20 ± 40.25 min in
Sitting group and Lateral group respectively. Conclusion – 0.5% plain levobupivacaine when used in
parturients for spinal anaesthesia for caesarean sections produces early onset of sensory blockade, and
shorter time for maximum motor blockade and also higher sensory level in sitting position than in lateral
position. However, there was no difference in the duration of sensory and motor blockade.