Document Detail

Assessment of the level of sensory block after subarachnoid anesthesia using a pressure palpator.
MedLine Citation:
PMID:  9972764     Owner:  NLM     Status:  MEDLINE    
In a cross-over study, we compared two methods of assessing the level of sensory block during subarachnoid anesthesia: the traditional pinprick sensation or a novel pressure palpator exerting a pressure of 650 g. Fifty patients scheduled for transurethral surgery under subarachnoid anesthesia were randomly assigned to be tested for spread of sensory block. In Group 1, the pressure palpator was followed by pinprick; in Group 2, the reverse sequence was used. Evaluation was performed 15 and 25 min after the subarachnoid injection of 2 mL of 5% lidocaine hyperbaric solution. In Group 1, the level of sensory block assessed with the pressure palpator was 1.7 +/- 3.2 cm (0.5 +/- 1.2 dermatomes) higher than that with the pinprick at 15 min, and 2.2 +/- 3.4 cm (0.6 +/- 1.0 dermatomes) higher than that with the pinprick 25 min after the block. In Group 2, the difference was accentuated. The level of sensory block assessed by pinprick 15 min after subarachnoid lidocaine was 5.7 +/- 4.8 cm (1.2 +/- 0.9 dermatomes) lower than the level with the pressure palpator, and 4.2 +/- 3.3 cm (0.9 +/- 0.6 dermatomes) lower than that with the pressure palpator at 25 min. In all instances, the pressure palpator gave a significantly higher assessment than the pinprick. We conclude that the pressure palpator, when preceded by the pinprick test, is associated with an increased threshold. This method may be useful in assessing the sensory block produced by subarachnoid anesthesia. Implications: A novel pressure palpator that maintains the integrity of the epidermis was used to assess the level of sensory block after subarachnoid anesthesia and was compared with the standard method of the pinprick sensation. This method assessed the block consistently higher than the pinprick method, but it may have advantages as a noninvasive sensory test.
A Fassoulaki; C Sarantopoulos; M Zotou; G Karabinis
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  88     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-02-23     Completed Date:  1999-02-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  398-401     Citation Subset:  AIM; IM    
Department of Anesthesia, St. Savas Hospital, Athens, Greece.
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MeSH Terms
Anesthesia, Spinal / instrumentation,  methods*
Anesthetics, Local / administration & dosage
Cross-Over Studies
Lidocaine / administration & dosage
Nerve Block / methods
Neurons, Afferent / drug effects
Pain Threshold / drug effects
Palpation / instrumentation*
Papilloma / surgery
Sensation / drug effects*
Sensory Thresholds / drug effects
Subarachnoid Space
Time Factors
Touch / drug effects
Urinary Bladder Neoplasms / surgery
Reg. No./Substance:
0/Anesthetics, Local; 137-58-6/Lidocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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