• A&A practice · May 2020

    Case Reports

    Case Series of Adaptive Changes in Clinical Practice and Trainee Education for Cesarean Delivery due to Drug Shortages of 0.75% Hyperbaric Bupivacaine in 2018.

    • Kokila N Thenuwara, Franklin Dexter, Unyime S Ituk, and David Weetman.
    • From the University of Iowa, Iowa City, IA.
    • A A Pract. 2020 May 1; 14 (7): e01214.

    AbstractHyperbaric bupivacaine, the local anesthetic routinely selected for single-injection spinal anesthesia for cesarean delivery (CD), was in short supply in 2018. Hospital stocks were significantly less than before and after the shortage period. We developed a contingency plan to communicate with pharmacy and retrieve, restrict, and reallocate remaining stocks of drug to continue performing CD under neuraxial anesthesia, specifically spinal anesthesia for emergency CD, when time appropriate. Retrospective chart review revealed that elective and emergency CDs were performed without delays or increase in rate of general anesthesia during this period. However, trainees had fewer opportunities to perform spinal anesthesia for CD.

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