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Local anesthetics and opioids used for spinal anesthesia for cesarean delivery

Local anesthetics and opioids used for spinal anesthesia for cesarean delivery
Drug Dose Duration*
Local anesthetic
Bupivacaine 8 to 12 mg 90 minutes
Ropivacaine 15 to 20 mg 90 minutes
Levobupivacaine 7.5 to 15 mg 90 minutes
Opioids
Fentanyl 10 to 20 mcg 3 to 4 hours
Sufentanil 2.5 to 10 mcg 3 to 4 hours
Morphine 75 to 150 mcg 10 to 24 hours
Hydromorphone 75 mcg 5 to 15 hours
Bupivacaine and ropivacaine are the local anesthetics most commonly used for CD in the United States. Outside the United States, levobupivacaine is used as well. This table should be used in conjunction with UpToDate content on anesthesia for cesarean delivery.

CD: cesarean delivery; NSAIDs: nonsteroidal anti-inflammatory drugs.

* For local anesthetics, duration of action is defined as time to two spinal segment regression. For opioids, duration of action is usually defined as time to first request for analgesia.

¶ Duration of action of hydrophilic opioids varies widely and may depend on administration of systemic analgesics (eg, NSAIDs).

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