LOW-DOSE HYPERBARIC BUPIVACAINE FOR UNILATERAL SPINAL-ANESTHESIA

Citation
A. Casati et al., LOW-DOSE HYPERBARIC BUPIVACAINE FOR UNILATERAL SPINAL-ANESTHESIA, Canadian journal of anaesthesia, 45(9), 1998, pp. 850-854
Citations number
21
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Anesthesiology
ISSN journal
0832-610X
Volume
45
Issue
9
Year of publication
1998
Pages
850 - 854
Database
ISI
SICI code
0832-610X(1998)45:9<850:LHBFUS>2.0.ZU;2-Z
Abstract
Purpose: To evaluate the effects of hyperbaric bupivacaine concentrati on in producing unilateral spinal anaesthesia. Methods: With Ethical C ommittee approval and written consent, 60 patients undergoing lower li mb surgery were placed in the lateral position with the side to be ope rated on dependent. After dural puncture (25-gauge Whitacre spinal nee dle), the needle hole was turned toward the dependent side and patient s were randomly assigned to receive 8 mg of either 0.5% (Group(0.5%), n = 30) or 1% (Group(1%), n = 30) hyperbaric bupivacaine, The lateral position was maintained for 15 min, while a blinded observer recorded loss of pinprick sensation and degree of motor block on both sides unt il two segment regression of sensory level on the dependent side. Resu lts: At the end of the 15 min lateral position spinal anaesthesia was more frequently unilateral in Group(0.5%) (80%) than in Group(1%) (53% )(P < 0.05). However, 30 min after patients were turned supine, unilat eral spinal anaesthesia decreased to 60% of cases in Group(0.5%) and 4 0% of cases in Group(1%) (P = NS). The maximum sensory level on the de pendent side [T-10(L-1 - T-2) in Group(0.5%) and T-8 (T-12 - T-3) in G roup(1%)], time to reach it [20 (5 - 30) min in Group(0.5%) and 25 (10 - 35) min in Group(1%)], and time to two segment regression of sensor y level [80 (30 - 135) min in Group(0.5%) and 75 (20 - 135) min in Gro up(1%)] were similar in both groups. Conclusion: Highly concentrated s olutions of hyperbaric bupivacaine are not advantageous in obtaining a unilateral spinal anaesthesia, when a small anaesthetic dose is injec ted slowly through a Whitacre spinal needle.