Comparison of Two Different Spinal Anesthesia Techniques Using Levobupivacaine in Perianal Surgery

Abstract

A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : Ge ne ral or spi nal anest he si a, ca u dal bloc k, lo cal anest he si a or com bi na ti on of the se tech ni qu es may be used for ano rec tal sur gery. The best anest he tic tech ni qu e and medications are still debated. This study was per for med to com pa re the fe a si bi lity of the two spi nal anest he tic tech ni qu es, na mely, sadd le block and low spi nal anest he si a using pla in le vo bu pi va ca i ne in elec ti ve pe ri a nal sur gery. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : Fo urty ASA (Ame ri can So ci ety of Anest he si o logists) I-III pa ti ents we re ran do mi zed to re ce i ve eit her sadd le block (Gro up 1) or low spi nal anesthe si a (Gro up 2) with 1.5 mL pla in le vo bu pi va ca i ne. In both gro ups, the deg re e of mo tor and sen sory block, pe ri-and pos to pe ra ti ve si de ef fects, pa ti ent and sur ge on sa tis fac ti on, anal ge sic re qu i re ments as well as du ra ti ons of anest he si a, sur gery and pos ta nest he si a ca re unit we re re cor ded. R Re e s su ul lt ts s: : The me di an le vel of sen so ri al block was sig ni fi cantly hig her in Gro up 2 (p= 0.007). The sen so ri al block re ma i ned at sac ral der ma to mes in 35 % of pa ti ents in Gro up 1 and in no ne of the pa ti ents in Group 2 (p= 0.008). Bro ma ge sco res we re "0" in 70 % and 21.1 % of pa ti ents in Gro up 1 and Gro up 2, res pec ti vely (χ 2 : 9.39, p= 0.002). Se ven te en pa ti ents in Gro up 1 and seven pa ti ents in Gro up 2 ac hie ved fast trac king cri te ri a in the ope ra ting ro om and we re ab le to bypass the pos ta nest he si a ca re unit (χ 2 : 11.493, p= 0.001). C Co on nc c l lu u s si i o on n: : Sadd le block with pla in le vo bu pi va ca i ne used for pe ri a nal surgery re sul ted in ab sen ce or less mo tor block, less ad mis si on to pos ta nest he si a ca re unit, fas ter re covery when com pa red to low spi nal anest he si a; however si de ef fects, pa ti ent and sur ge on sa tis fac ti on we re com pa rab le bet we en the gro ups.K Ke ey y W Wo or rd ds s: : Anest he si a, con duc ti on; anest he si a, spi nal; le vo bu pi va ca i ne Ö ÖZ ZE ET T A Am ma aç ç: : Ge nel ve ya spi nal anes te zi, ka u dal blok, lo kal anes te zi ya da bu tek nik le rin kom bi nasyo nu ano rek tal cer ra hi için kul la nı la bi lir. Han gi anes te zi tek ni ği ve ila cın en iyi se çim ol du ğu hala tar tış ma lı dır. Bu ça lış ma elek tif pe ri a nal cer ra hi de saf le vo bu pi va ka in kul la na rak ya pı lan iki spi nal anes te zi tek ni ği nin, ya ni sadd le blok ve dü şük se vi ye li spi nal anes te zi nin uy gu la na bi lir li ği nin kar -şı laş tı rıl ma sı ama cıy la ya pıl dı. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Kırk ASA (Ame ri kan Anes te zi yo lo jist ler Derne ği) I-II I has ta 1.5 ml saf le vo bu pi va ka in ile sadd le blok (Grup 1) ve ya dü şük se vi ye li spi nal anes te zi (Grup 2) uy gu lan mak için ran do mi ze edil di. Her iki grup ta da, mo tor ve du yu sal blok dü zey...

Obturator Nerve Block Using Levobupivacaine for the Prevention of Adductor Spasm in Transurethral Bladder Tumor Resection

“…In this study levobupivacaine was chosen because of its equivalent effect to bupivacaine with a better safety profile in cardiovascular and central nervous system toxicity. 18,19 In conclusion, the results of this study suggested that obturator block performed using 10 ml 3.75% levobupivacaine was effective in preventing adductor spasm in patients scheduled for TUR-BT under spinal anesthesia for the resection of lateral bladder wall tumours and resulted with better surgeon satisfaction and better surgical conditions.…”