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Low-dose spinal anaesthesia for Caesarean section to prevent spinal-induced hypotension

Roofthooft, Evaa; Van de Velde, Marcb

Current Opinion in Anaesthesiology:
doi: 10.1097/ACO.0b013e3282ff5e41
Obstetric and gynecological anesthesia: Edited by Marc Van de Velde

Purpose of review: The present review evaluates the evidence available in the literature to see whether low-dose spinal anaesthesia for Caesarean section is effective in preventing maternal hypotension while at the same time guaranteeing effective anaesthetic conditions.

Main findings: From prospective trials, it is clear that lowering the spinal dose improves maternal haemodynamic stability. Doses of intrathecal bupivacaine between 5 and 7 mg are sufficient to provide effective anaesthesia. Complete motor block is, however, seldom achieved and adequate anaesthesia is limited in time.

Summary: Low-dose spinal anaesthesia as part of a combined spinal–epidural technique is a valuable method in improving maternal and fetal outcome during anaesthesia for operative delivery.

Author Information

aDepartment of Anesthesiology, ZNA Middelheim Hospital, Antwerp, Belgium

bDepartment of Anesthesiology, University Hospital Gasthuisberg, UZ Leuven, Leuven, Belgium

Correspondence to Marc Van de Velde, MD, PhD, Director Obstetric Anaesthesia and Extra Muros Anaesthesia, Department of Anaesthesiology, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium Tel: +32 16 34 42 70; fax: +32 16 34 42 45; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.