P297 Departmental review of BMI, intrathecal drug dosing and haemodynamic stability in caesarean sections under spinal anaesthesia

Résumé fourni par la source

Application for ESRA Abstract Prizes: Background and Aims Optimal dosing of intrathecal local anaesthetics and adjuvants like fentanyl and morphine can be influenced by patient-specific factors, particularly Body Mass Index (BMI). Furthermore, spinal-induced hypotension is a frequent complication, with vasopressor support often required. This audit aims 1. To assess spinal dosing practices (bupivacaine + adjuvants). 2. To evaluate BMI variations, block heights achieved and hemodynamic outcomes. Methods Prospective data collection. 30 patients(April–June 2025) undergoing caesarean under spinal anaesthesia. • BMI categorization, • Dose of 0.5% hyperbaric bupivacaine (ml), • Sensory block height before surgical draping, • Vasopressor use (yes/no) Standardized data sheets were filled. Results The Body Mass Index (BMI) distribution: one patient (3.3%) was underweight (BMI <18.5), 12 patients (40%) had a normal BMI (18.5–24.9), five patients each (16.6%) fell into the overweight (25–29.9) and obese class I (30–34.9) categories, seven patients (23.3%) had a BMI of 35 and above. Dosing of bupivacaine: two patients (6.6%) received 1.8–2.0 ml, twelve patients (40%) received 2.1–2.2 ml, and fifteen patients (50%) received 2.3–2.5 ml, 1 case N/D. Below T6 level 1(3.3%), three patients (10%) between T5 and T6, and sixteen patients (53.3%) at the desired T4 level. Two patients (6.6%) had a block height higher than T4. However, in eight cases (26.6%), the sensory level was not documented. Vasopressor or inotrope use was recorded in twenty-one patients (70%), while the remaining nine patients (30%) did not require inotropes. Conclusions The audit highlights a tendency towards higher than recommended bupivacaine dosing, with significant vasopressor use, and inconsistencies in sensory level documentation.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.