Document Detail


Low-dose spinal hyperbaric bupivacaine for adult anorectal surgery: a double-blinded, randomized, controlled study.
MedLine Citation:
PMID:  20006254     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: To produce selective spinal anesthesia for adult anorectal surgery.
STUDY DESIGN: Double-blinded, randomized, controlled trial.
SETTING: Operating room and postoperative recovery area.
PATIENTS: 152 adult, consecutive ASA physical status I, II, and III patients.
INTERVENTIONS: After patients underwent dural puncture in the sitting position at L3-L4 or L4-L5, 0.5% hyperbaric bupivacaine was injected over two minutes: Group S7.5 received 1.5 mL, Group S5 received 1.0 mL, and Group S4 0.8 mL. After sitting for 10 minutes, patients were positioned for surgery.
MEASUREMENTS: Rate of success, level and duration of sensory and motor block, time to voiding and ambulation, complications, and quality of anesthesia according to the patient and medical staff, were recorded.
RESULTS: Spinal block had a 98% rate of success. Mean level of sensory block was 10.4 +/- 1.7, 7.4 +/- 2.2, and 7.0 +/- 1.8 dermatomes in Groups S7.5, S5, and S4 (P < 0.01 S7.5 vs S5, and S7.5 vs S4). Mean duration of sensory block was 310.5 +/- 42.6, 255.9 +/- 43.7, and 228.8 +/- 34.8 min in Groups S7.5, S5, and S4 (P < 0.01 S7.5 vs S5, S7.5 vs S4, and S5 vs S4). Motor block was Bromage score 2-3 in 70.5% of Group S7.5 patients versus Bromage score 0-1 in 97.3% of Group S5 and 92.1% of Group S4 patients (P < 0.05).
CONCLUSION: A dose of 4 mg of hyperbaric bupivacaine produces a similar level of sensory and motor block as a 5 mg dose but with shorter duration and faster recovery.
Authors:
Jurate Gudaityte; Irena Marchertiene; Aurika Karbonskiene; Zilvinas Saladzinskas; Algimantas Tamelis; Igoris Toker; Dainius Pavalkis
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  21     ISSN:  1873-4529     ISO Abbreviation:  J Clin Anesth     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-02-19     Revised Date:  2011-04-14    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  474-81     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Kaunas University of Medicine Hospital, Kaunas, LT 50009, Lithuania. jurate.gudaityte@kmuk.lt
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MeSH Terms
Descriptor/Qualifier:
Adult
Anal Canal / surgery*
Anesthesia, Spinal*
Anesthetics, Local* / administration & dosage,  adverse effects
Blood Pressure / drug effects
Bupivacaine* / administration & dosage,  adverse effects
Double-Blind Method
Female
Heart Rate / drug effects
Humans
Male
Middle Aged
Nerve Block
Pain Measurement / drug effects
Pain, Postoperative / prevention & control
Postoperative Complications / epidemiology
Preanesthetic Medication
Prospective Studies
Rectum / surgery*
Sample Size
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 2180-92-9/Bupivacaine
Comments/Corrections
Comment In:
J Clin Anesth. 2011 Mar;23(2):169; author reply 169   [PMID:  21377086 ]

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


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