КОРИСТЕЊЕ ЛОКАЛЕН АНЕСТЕТИК ЗА ЦАРСКИ РЕЗ
USING LOCAL ANESTHETIC FOR CESAREAN SECTION

Summary/Abstract: Cesarean section is becoming increasingly common worldwide and in Macedonia. It is a surgical procedure used to deliver a baby through an incision in the lower abdomen. The surgery usually takes about 30 minutes but may take longer in complicated cases. Recovery takes longer than with vaginal birth, and like any surgery, a C section carries some risks. However, these are rare due to advances in surgical techniques and anesthesia. The choice of anesthesia depends on each womanfs specific situation, as what works for one may not be suitable for another. Spinal Anesthesia in Cesarean Section: Isobaric vs. Hyperbaric Bupivacaine Bupivacaine is used in spinal anesthesia in both isobaric (dextrose free) and hyperbaric (with dextrose) forms. These forms differ in how they affect block onset, duration, and hemodynamic stability. Delayed block onset with isobaric bupivacaine can increase time in the supine position, raising the risk of aortocaval compression and hypotension, which may harm both mother and baby. In a study of 60 women, 30 received isobaric and 30 hyperbaric bupivacaine to compare these effects. Isobaric vs. Hyperbaric Bupivacaine in Cesarean Section Group I (Isobaric): 30 women received 11 mg bupivacaine + 10 ƒÊg fentanyl. ¨ 20 had hypotension (treated with ephedrine), 10 had bradycardia (treated with atropine). Group II (Hyperbaric): 30 women received 6 8 mg bupivacaine + 20 ƒÊg fentanyl. ¨ 10 had hypotension (treated with ephedrine), 5 had tachycardia (treated with phenylephrine). Hyperbaric bupivacaine is the standard for spinal anesthesia in cesarean sections due to its predictable spread, rapid onset, and reliable block control. Isobaric bupivacaine is used less often, mainly in special or experimental cases, as its effects are more variable and less predictable. Hyperbaric bupivacaine is preferred for its predictability, while isobaric bupivacaine is used less due to variable effects.

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