Effect of abdominal circumference on spread of intrathecal heavy bupivacaine in parturient undergoing cesarean section: An observational study.

Background: Spinal anesthesia is a widely preferred anesthetic technique for cesarean section but often leads to adverse effects such as nausea, vomiting, hypotension, bradycardia, and shivering, which are primarily attributed to increased intra-abdominal pressure. Since abdominal circumference correlates with intra-abdominal pressure in parturients, the objective is to investigate how abdominal circumference influences the spread of intrathecal heavy bupivacaine following spinal anesthesia during cesarean section. Methodology: A total of 78 pregnant women with singleton gestation undergoing cesarean section under spinal anesthesia were enrolled in the study. Preoperative parturient abdominal circumference was measured. Lumbar puncture was performed at the L3-L4 interspinous space using a Quincke 25-gauge spinal needle with a midline approach in the sitting position, followed by the intrathecal administration of 2 mL of 0.5% heavy bupivacaine. The cephalic spread of local anesthetic was assessed by evaluating the dermatomal level of cold-sensation loss at 1, 3, 5, 10, and 15 minutes following spinal anesthesia. Kendall's tau correlation analysis was used to assess the relationship between parturient abdominal circumference and the sensory block level at various time intervals. Results: No correlation was found between parturient abdominal circumference and the level of loss of cold sensation at various time intervals. The incidence rates of adverse effects were as follows: hypotension (44.4%), bradycardia (4.2%), nausea (4.2%), vomiting (2.8%), and shivering (18.1%). Conclusion: Our study found no correlation between parturient abdominal circumference and the intrathecal spread of heavy bupivacaine following spinal anesthesia during cesarean section.