Saratov JOURNAL of Medical and Scientific Research

Evaluation of latent period of temperature sensitivity in traditional and unilateral spinal anesthesia

Year: 2015, volume 11 Issue: №3 Pages: 263-267
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Lakhin R.E., Panov V.A., Schegolev A.V., Kuligin A.V.
Organization: Military Medical Academy n.a. S. M. Kirov, Saratov State Medical University
Summary:

Objective: evaluation of the differences in the level of temperature, sensory and motor blockade during the various techniques of spinal anesthesia. Materials and Methods. Prospectively the randomized study included 70 patients. In the group with conventional spinal anesthesia (n=35) 15mg of bupivacaine injected quickly. In the group with unilateral spinal anesthesia (n=35) 7.5mg of bupivacaine administered slowly, at a rate of 1 ml per minute. We studied the level of temperature and time, sensory and motor blockade. The data are statistically processed. Results. Reduced thermal sensitivity recorded in an average of 48 seconds as a unilateral spinal anesthesia group and the control group. Subarachnoid administration of 7.5 mg of hyperbaric bupivacaine resulted in the development of a complete motor blockade underlying lower extremity in only 16 patients (45.7%). Conclusion. Using lower dosages of bupivacaine for unilateral spinal anesthesia lowers the threshold concentration of the local anesthetic in the subarachnoid space, resulting in slower motor neuron blockade and it is not total in more than 50% of cases.

Bibliography:
1. Gasser HS, Erlanger J. Role of size in establishment of nerve block by pressure or cocaine. Am J Physiol 1929; 88: 581-589
2. Hocking G, Wildsmith JW. Intrathecal drug spread. British Journal of Anaesthesia 2004; 93: 568-78
3. Man'kov AV, Pavljuk AL, Evseev BK. Hemodynamic complications of neuraxial anesthesia. Siberian Medical Journal 2009; 90: 19-22
4. Kocarev М, Watkins Е, McLure Н, et al. Sensory testing of spinal anaesthesia for caesarean section: differential block and variability. Int J Obstet Anesth 2010; (10): 261-265
5. Gorbachev VI, Man'kov AV. Optimization of spinal anesthesia in surgery of intervertebral discs. General Intensive Care 2006; (5-6): 178-183
6. Instructions for use of the drug for medical use Marcaine Spinal Heavy, http://www.astrazeneca.ru/medicines/anaesthesi-ology (23092014). 7. Zharnikov AV. Partial segmental anesthesia in patients of older age groups. Yakut Medical Journal 2012; 3 (39): 24-27
8. Casati A, Fanelli G, Cappelleri G, et al. Does speed of intrathecal injection affect the distribution of hyperbaric bupiva-caine? Br J Anaesth 1998; 81: 355-357
9. Liu S, Kopacz DJ, Carpenter RL. Quantitative assessment of differential sensory nerve block after lidocaine spinal anesthesia. Anesthesiology 1995; 82 (1): 60-63
10. Grover BA, Rush JM, Servoss MM. Assessing sensory blockade with alcohol and pinprick after subarachnoid block. AANAJ 1998; 66(1): 77-81
11. Brull SJ, Greene NM. Time-Courses of Zones of Differential Sensory Blockade during Spinal Anesthesia with Hyperbaric Tetracaine or Bupivacaine. Anesth Analg 1989; 69 (3): 342-347
12. Russell IF. A comparison of cold, pinprick and touch for assessing the level of spinal block at caesarean section. Int J Obstet Anesth 2004; 13: 146-152
13. Ousley R, Egan C, Dowling К, Супа AM. Assessment of block height for satisfactory spinal anaesthesia for caesarean section. Anaesth2012; 67: 1356-1363
14. Liu S, Ware P. Differential Sensory Block After Spinal Bupivacaine in Volunteers. Anesth Analg 1997; 84 (1): 115-119.

AttachmentSize
2015_03_263-267.pdf307.5 KB

No votes yet