Comparison of Spinal Block Levels between Laboring and Nonlaboring Parturients Using Combined Spinal Epidural Technique with Intrathecal Plain Bupivacaine

Background. It was suggested that labor may influence the spread of intrathecal bupivacaine using combined spinal epidural (CSE)
technique. However, no previous studies investigated this proposition. We designed this study to investigate the spinal block
characteristics of plain bupivacaine between nonlaboring and laboring parturients using CSE technique. Methods. Twenty-five
nonlaboring (Group NL) and twenty-five laboring parturients (Group L) undergoing cesarean delivery were enrolled. Following
identification of the epidural space at the L3-4 interspace, plain bupivacaine 10 mg was administered intrathecally using CSE
technique. The level of sensory block, degree of motor block, and hemodynamic changes were assessed. Results. The baseline
systolic blood pressure (SBP) and the maximal decrease of SBP in Group L were significantly higher than those in Group NL
(P = 0.002 and P = 0.03, resp.). The median sensory level tested by cold stimulation was T6 for Group NL and T5 for Group L (P =
0.46). The median sensory level tested by pinprick was T7 for both groups (P = 0.35). The degree of motor block was comparable
between the two groups (P = 0.85). Conclusion. We did not detect significant differences in the sensory block levels between
laboring and nonlaboring parturients using CSE technique with intrathecal plain bupivacaine.