P297 Departmental review of BMI, intrathecal drug dosing and haemodynamic stability in caesarean sections under spinal anaesthesia

<h3></h3> <b>Application for ESRA Abstract Prizes:</b> <h3>Background and Aims</h3> Optimal dosing of intrathecal local anaesthetics and adjuvants like fentanyl and morphine can be influenced by patient-specific factors, particularly Body Mass Index (BMI). Furthermore, spinal-induced hypotension is a frequent complication, with vasopressor support often required. This audit aims 1. To assess spinal dosing practices (bupivacaine + adjuvants). 2. To evaluate BMI variations, block heights achieved and hemodynamic outcomes. <h3>Methods</h3> Prospective data collection. 30 patients(April–June 2025) undergoing caesarean under spinal anaesthesia. • BMI categorization, • Dose of 0.5% hyperbaric bupivacaine (ml), • Sensory block height before surgical draping, • Vasopressor use (yes/no) Standardized data sheets were filled. <h3>Results</h3> The Body Mass Index (BMI) distribution: one patient (3.3%) was underweight (BMI &lt;18.5), 12 patients (40%) had a normal BMI (18.5–24.9), five patients each (16.6%) fell into the overweight (25–29.9) and obese class I (30–34.9) categories, seven patients (23.3%) had a BMI of 35 and above. Dosing of bupivacaine: two patients (6.6%) received 1.8–2.0 ml, twelve patients (40%) received 2.1–2.2 ml, and fifteen patients (50%) received 2.3–2.5 ml, 1 case N/D. Below T6 level 1(3.3%), three patients (10%) between T5 and T6, and sixteen patients (53.3%) at the desired T4 level. Two patients (6.6%) had a block height higher than T4. However, in eight cases (26.6%), the sensory level was not documented. Vasopressor or inotrope use was recorded in twenty-one patients (70%), while the remaining nine patients (30%) did not require inotropes. <h3>Conclusions</h3> The audit highlights a tendency towards higher than recommended bupivacaine dosing, with significant vasopressor use, and inconsistencies in sensory level documentation.