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Influence of Epinephrine on the Spread of 0.75% Bupivacaine in Epidural Anesthesia for Cesarean Section
  1. José Carlos Almeida Carvalho, MD,
  2. Roberto Simão Mathias, MD,
  3. Waldir Garcia Senra, MD and
  4. Eugesse Cremonesi, MD
  1. From the Departments of Anesthesiology and Pharmacology, University of São Paulo, Brazil


Four hundred and six term pregnant patients, undergoing elective cesarean section, received epidural anesthesia with 150 mg of 0.75% bupivacaine. They were allocated to three different groups, depending on the concentration of epinephrine added to the local anesthetic solution (1:200,000, 1:400,000 or none). The extension of the sensory blockade was studied in terms of total number of blocked segments and of blocked segments above the puncture site. In the group receiving bupivacaine and epinephrine 1:200,000, the total number of blocked segments (18.1 ± 1.6) and the number of blocked segments above the puncture site (10.3 ± 1.6) were greater ( p < 0.01) than in the other two groups. No significant differences were determined between the groups receiving epinephrine 1:400,000 or plain solutions. The addition of epinephrine 1:200,000, but not of epinephrine 1:400,000, to the local anesthetic solution will lead, in the studied circumstances, to a greater extension of the sensory blockade.

  • Anesthesia
  • obstetrical
  • Anesthetic technique
  • epidural
  • Anesthetics
  • local
  • bupivacaine
  • Vasoconstrictors
  • epinephrine

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