High-volume spinal anesthesia with bupivacaine 0.125% for cesarean section

This study showed that the suggested test dose for epidural block (10 ml of bupivacaine 0.125% plus epinephrine 1:800,000) is effective and probably safe if injected intrathecally in the obstetric patient; a clearly detectable anesthetic level and motor block are present within a few minutes, without causing an unacceptable high level of anesthesia or hemodynamic decompensation. Hypotension, a common complication of spinal and epidural anesthesia, was never a serious problem in this study despite the fact that intravenous fluid administration was not aggressive. We also showed that the subarachnoid administration of a high-volume, low-concentration bupivacaine solution results in a predictable and solid spinal block which allows cesarean section to be performed without the least discomfort to the patient and without any obvious harm to the fetus.