Spinal Anaesthesia with Bupivacaine 0.5% hyperbaric + Fentanyl 10 µg
(Bupivacaine dose according to height: < 150 cm 8mg, > 150 cm 10mg, > 160 cm 12mg, > 180 cm 15mg), Sprotte or Whitacre needle.
Volume handicapped (RL 500 - 1000 ml)
Puncture in right side, after that, immediate positioning on back (lift right hip 30°), a T4 level should be achieved, check blood pressure every minute, give ephedrine 5 to 10 mg i.v. for hypotension (systolic < 100), O2
Attention: spinal anaesthesia is not recommended for preeclampsia (peracute circulatory problems), caution in cases of diabetes mellitus and obesity (autonomous neuropathy or Hypovolaemia)
Epidural Anaesthesia with Lidocaine-CO2 2% + Adrenaline 1/200 000 in divided doses of a max. 5 ml until T4 level is achieved (on average, 16 to 24 ml); for Preeclampsia, use Bupivacaine 0.5% (No Adrenaline!)
Attention: Bupivacaine 0.75% is contraindicated for obstetric anaesthesia !
Note: Nitrog. 50 to 100 µg iv can lead to relaxation of the uterus, which may make a difficult delivery easier.
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