Spinal Ropivacaine For Cesarean Sectionm
Posted Date: Apr 22, 2024
- Investigator: Andrea Girnius
- Specialties: Obstetrics, Women's Health
- Type of Study: Observational/Survey
Spinal anesthesia is the gold standard anesthetic technique for C/S. Hyperbaric 0.75% bupivacaine (Spinal Marcaine) is FDA approved for spinal anesthesia and is currently used for most spinal anesthetics. Other local anesthetics have been used historically for spinal anesthesia for a variety of procedures, and some are still used, although this is less common. Many currently practicing anesthesia providers do not have any experience using anything other than Spinal Marcaine. As drug shortages have become more and more common, it is important to be able use alternative medications without compromising patient care. In January 2023, our health care system experienced a shortage of Spinal Marcaine. We were not able to obtain any spinal Marcaine for several months. The Society fo Obstetric Anesthesia and Perinatology provides recommendations for C/S anesthesia during drug shortages, but their recommended alternative (0.5% isobaric bupivacaine) was also unavailable.(1) A literature search revealed rare publications on using any other local anesthetic for Cesarean delivery, making it difficult to determine which local anesthetic would be a suitable substitute. Most local anesthetics used for other surgeries were not appropriate for use during Cesarean delivery based on onset, duration of block, or side effect profile. Based on a few small studies in the obstetric population (2-4) and commercial availability, we began using 1% ropivacaine for spinal anesthesia once we were no longer able to obtain Spinal Marcaine. Based on the paucity of literature surrounding its use for spinal anesthesia, we think that reporting our experience using this medication would be valuable to the obstetric anesthesia community.
Criteria:
All Patients Who Received Ropivacaine 1% For A Spinal Anesthetic For Cesarean Section At Ucmc Over The Age Of 18
Keywords:
Obstetric Anesthesia, Cesarean Section, Drug Shortage
For More Information:
Andrea Girnius
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girniuaa@ucmail.uc.edu