The influence of body mass index on sensorimotor block and vasopressor requirement during spinal anaesthesia for elective caesarean section
type: CreativeWork
description: Background: It has been suggested that the dose requirement for spinal anesthesia (SA) is lower in obese patients for cesarean delivery. In this prospective, observational, non-inferiority study we tested the hypothesis that obesity would not have a clinically important effect on vasopressor requirements or block height. Methods: Two groups of 25 parturients, Group O (BMI >40 kg/m²) and Group N (BMI <32 kg/m²) requiring elective cesarean delivery were recruited. All patients received 10 mg intrathecal hyperbaric bupivacaine co-administered with 10 μg fentanyl. Dermatomal levels were assessed at 5 and 25 minutes after SA, and at completion of surgery, using light touch and cold sensation in response to ethyl chloride. The primary outcomes were phenylephrine requirement in the first thirty minutes following spinal anesthesia, and maximum block height, measured by the sensation of touch and cold. Secondary outcomes were total phenylephrine dose required, changes in hand grip strength, and peak flow rate. Results: There were no significant between-group differences in median block height as assessed by touch at 5 or 25 minutes, or by temperature at 5 minutes. At 25 minutes, there was a two-dermatome difference in median block height for loss of temperature sensation between Group O and Group N (T2 vs. T4, 95% confidence interval (CI) of the difference in medians 0-2 dermatomes). No blocks extended to cervical dermatomes. The median (range) phenylephrine dose for the first 30 minutes was 150 μg (0-900 μg), and 100 μg (0-1250 μg) in Group N and O respectively. The 95% CI for the difference between the two median doses was -150 μg to 100 μg. There were no differences in median percentage reductions in peak flow rate or median hand grip strength after SA. Mean surgical time was longer in Group O than in Group N (49.1 vs 39.4 minutes, 95% CI difference 1.7 to 17.7 minutes). The mean time for recovery of touch sensation to T10 was longer in Group O (152 vs 132 minutes, 95% CI…
abstract: Background: It has been suggested that the dose requirement for spinal anesthesia (SA) is lower in obese patients for cesarean delivery. In this prospective, observational, non-inferiority study we tested the hypothesis that obesity would not have a clinically important effect on vasopressor requirements or block height. Methods: Two groups of 25 parturients, Group O (BMI >40 kg/m²) and Group N (BMI <32 kg/m²) requiring elective cesarean delivery were recruited. All patients received 10 mg intrathecal hyperbaric bupivacaine co-administered with 10 μg fentanyl. Dermatomal levels were assessed at 5 and 25 minutes after SA, and at completion of surgery, using light touch and cold sensation in response to ethyl chloride. The primary outcomes were phenylephrine requirement in the first thirty minutes following spinal anesthesia, and maximum block height, measured by the sensation of touch and cold. Secondary outcomes were total phenylephrine dose required, changes in hand grip strength, and peak flow rate. Results: There were no significant between-group differences in median block height as assessed by touch at 5 or 25 minutes, or by temperature at 5 minutes. At 25 minutes, there was a two-dermatome difference in median block height for loss of temperature sensation between Group O and Group N (T2 vs. T4, 95% confidence interval (CI) of the difference in medians 0-2 dermatomes). No blocks extended to cervical dermatomes. The median (range) phenylephrine dose for the first 30 minutes was 150 μg (0-900 μg), and 100 μg (0-1250 μg) in Group N and O respectively. The 95% CI for the difference between the two median doses was -150 μg to 100 μg. There were no differences in median percentage reductions in peak flow rate or median hand grip strength after SA. Mean surgical time was longer in Group O than in Group N (49.1 vs 39.4 minutes, 95% CI difference 1.7 to 17.7 minutes). The mean time for recovery of touch sensation to T10 was longer in Group O (152 vs 132 minutes, 95% CI…
author: Ngaka, Tshebeletso Christian
language: eng
date published: 2017
date modified: 2026-07-22T22:22:54Z
provider: University of Cape Town
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Anaesthesia

PropertyValue
property ID: Handle
value: http://hdl.handle.net/11427/24485