Epidural anaesthesia for caesarean section: a comparison of 0.5% bupivacaine and 2% lignocaine both with adrenaline.

Thirty-eight women having caesarean section under epidural anaesthesia received either lignocaine 2% or bupivacaine 0.5% both with adrenaline 1:200,000 in a double-blind, randomised study. The time to establish satisfactory surgical anaesthesia, the volume required and the quality of analgesia as assessed by the anaesthetist, patient pain and discomfort scales and patient approval, were not significantly different. Motor block assessed by the Bromage and RAM-test was greater in the lignocaine group but surgical opinion of abdominal wall relaxation was not significantly different between groups. The bupivacaine group had significantly longer durations of sensory and motor block while the lignocaine group had a higher incidence of maternal shivering, other complication rates being similar. Neonatal outcomes were uniformly good. Both local anaesthetics provided satisfactory epidural anaesthesia and neither proved to have a distinct advantage in the clinical setting of this study.