Saratov JOURNAL of Medical and Scientific Research

Low dose spinal anesthesia for knee arthroscopy

Year: 2015, volume 11 Issue: №2 Pages: 126-128
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Lakhin R.E., Schegolev A.V., Panov V.A., Kuligin A.V.
Organization: Military Medical Academy n.a. S. M. Kirov, Saratov State Medical University
Summary:

Objective: to evaluate the nature of unilateral spinal anesthesia using various modes of administration of low doses of hyperbaric bupivacaine. Materials and Methods. Prospectively, the randomized study included 56 patients undergoing knee arthroscopy. In the control group bupivacaine of 5mg was administered simultaneously, in the main group — fractionally by 2.5 mg. The development of thermal and pain blocks from different sides was investigated. The data were statistically processed. Results. In the control group, the positioning of the patient usually began after the entire dose of anesthetic had been administered. In the case of temperature paresthesia in the area of the sacral segments of the full anesthesia throughout underlying limb was not always achieved. In 6 cases of block was not sufficient. In the main group patient positioning was performed after the administration of 2.5 mg of anesthetic and evaluate temperature paresthesia and in 2 cases the total dose was increased to 7.5 mg. The successful development of sensory block at fractional administration was significantly higher than in the single-step introduction. Conclusion. Temperature paresthesia occurs within the first minute and is an early predictor of developing spinal anesthesia. The area of arising paresthesia shows preferential distribution of the anesthetic. In the application of low dose local anesthetic the desired upper level of anesthesia via the patient positioning and dose adjustment may be achieved.

Bibliography:
1. Imbelloni LE, Beato L, Cordeiro LE. Unilateral spinal anesthesia with low dose 0.5% hyperbaric bupivacaine. Rev BrasAnestesiol 2004; 54 (5): 700-706
2. Meyer J, Enk D, Penner M. Unilateral spinal anesthesia using low-flow injection through a 29-gauge Quincke needle. Anesth Analg 1996; 82 (6): 1188-1191
3. Sanatkar M. The hemodynamic effects of spinal block with low dose of bupivacaine and sufentanil in patients with low myocardial ejection fraction. Acta Med Iran 2013; 7 (51): 438-443
4. Shrestha RR, Jha BD, Rana RB. Unilateral Spinal Anesthesia using Low Dose Hypobaric. Postgrad Med J 2008; 8(1): 118-123
5. Salinas FV, Sueda LF, Liu SS. Physiology of spinal anaesthesia and practical suggestions for successful spinal anaesthesia. Best Pract Res Clin Anaesthesiol 2003; 17 (3): 289-303
6. Atef H, El-Kasaby A, Omera M, Badr M. Optimal dose of hyperbaric bupivacaine 0.5% for unilateral spinal anesthesia during diagnostic knee arthroscopy. Local Reg Anesth 2010; 3 (1): 85-91
7. Nair GS, Ambrishami A, Lermitte J, Chung F. Systematic review of spinal anaesthesia using bupivacaine and Bupivacaine + Fentanyl in Ambulatory Arthroscopic Knee Surgery. Br J Anaesth 2009; 102 (3): 307-315
8. Korhonen AM, Valanne JV, Jokela RM, et al. Influence of the injection site (L2/3 or L3/4) and the posture of the vertebral column on selective spinal anesthesia for ambulatory knee arthroscopy. Acta Anaesthesiol Scand 2005; 49 (1): 72-77
9. Halvadia SH, Halvadia HB, Joshi RM, et al. Low Dose Bupivacaine-Fentanyl Vs. Conventional Dose Of Bupivacaine In Spinal Anesthesia For Orthopaedic Procedures In Elderly. Natl J Integr Res Med 2013; 1 (4): 49-55.

AttachmentSize
2015_02_126-128.pdf297.69 KB

No votes yet