EXTRADURAL BUPIVACAINE OR LIGNOCAINE ANAESTHESIA FOR ELECTIVE CAESAREAN SECTION: THE ROLE OF MATERNAL POSTURE

Extradural anaesthesia was induced in 64 patients in eitherthe sitting or the lateral position, for elective Caesareansection with either 0.5% plain bupivacaine or 2% lignocainewith adrenaline 1 in 200 000. Onset was significantly shorterand a significantly greater number of patients were ready forsurgery within 35 min following injection of lignocaine in thelateral position. Hypotension (defined as a 25% or greater reductionin arterial pressure) occurred in 36% of patients. Significantlymore patients who had received the first injection of localanaesthetic agent in the sitting position required ephedrineto correct maternal hypotension. Most frequently, hypotensioncoincided with transfer of patients to theatre and thus wasassociated with movement of the patient in the presence of extensivesympathetic block.