Obstetric anaesthesia: bupivacaine 0.75 percent: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Obstetric anaesthesia: bupivacaine 0.75 percent

Sample item

Which local anaesthetic preparation is contraindicated for obstetric epidural anaesthesia because of reports of cardiac arrest?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Bupivacaine 0.75%

Cardiac arrests resistant to resuscitation were reported after accidental intravascular injection of 0.75% bupivacaine during obstetric epidural anaesthesia. Pregnancy appears to increase sensitivity to its cardiotoxicity, so this concentration is not recommended for obstetric use. Lower concentrations, fractionated dosing and test doses are used instead.

Option by option

  • A. Bupivacaine 0.25%

    The 0.25% concentration is used in obstetric analgesia.

  • B. Ropivacaine 0.2%

    Ropivacaine 0.2% is a standard labour analgesia solution.

  • C. Bupivacaine 0.75% (correct)

    Correct. The 0.75% concentration has been linked to refractory cardiac arrest in obstetric patients.

  • D. Lignocaine 2%

    Lignocaine 2% is used for epidural top-up for caesarean section.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Bupivacaine 0.75%. Cardiac arrests resistant to resuscitation were reported after accidental intravascular injection of 0.

Why is "Bupivacaine 0.25%" not the answer?

The 0.25% concentration is used in obstetric analgesia.

Why is "Ropivacaine 0.2%" not the answer?

Ropivacaine 0.2% is a standard labour analgesia solution.

Why is "Lignocaine 2%" not the answer?

Lignocaine 2% is used for epidural top-up for caesarean section.

What concept does this question test?

It tests Obstetric anaesthesia: bupivacaine 0.75 percent in Anaesthesia. 75% bupivacaine during obstetric epidural anaesthesia. Pregnancy appears to increase sensitivity to its cardiotoxicity, so this concentration is not recommended for obstetric use. Lower concentrations, fractionated dosing and test doses are used instead.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Obstetric anaesthesia: bupivacaine 0.75 percent?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.