Obstetric Anesthesia

Anesthesia for Cesarean Delivery

ED₅₀ and ED₉₅ of Intrathecal Bupivacaine in Morbidly Obese Patients Undergoing Cesarean Delivery

Carvalho B, Collins J, Drover DR, et al (Stanford Univ School of Medicine, CA) Anesthesiology 114:529-535, 2011^§

Abstract

Background

It has been suggested that morbidly obese parturients may require less local anesthetic for spinal anesthesia. The aim of this study was to determine the effective dose (ED₅₀/ED₉₅) of intrathecal bupivacaine for cesarean delivery in morbidly obese patients.

Methods

Morbidly obese parturients (body mass index equal to or more than 40) undergoing elective cesarean delivery were enrolled in this double-blinded study. Forty-two patients were randomly assigned to receive intrathecal hyperbaric bupivacaine in doses of 5, 6, 7, 8, 9, 10, or 11 mg (n = 6 per group) coadministered with 200 μg morphine and 10 μg fentanyl. Success (induction) was defined as block height to pinprick equal to or more than T6 and success (operation) as success (induction) plus no requirement for epidural supplementation throughout surgery. The ED₅₀/ED₉₅ values were determined using a logistic regression model.

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