Effect of Baricity on Spinal Anaesthesia With Bupivacaine

Chambers, W. A.; Edström, H. H.; Scott, D.B.

doi:10.1093/bja/53.3.279

Cited by 127 publications

(69 citation statements)

References 1 publication

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“…The level of analgesia, degrees of sensory and motor blockade achieved with patients of both groups were similar. In studies done by Axelsson [22,23], Moller 4 and Chambers [24] the duration of block was longer with isobaric bupivacaine, which was not in agreement with our study. Our study showed that the onset, extent and duration of block were not affected by the drug concentration, which shows that the mass of the drug injected is more important than the concentration.…”

Section: Duration Of Blockcontrasting

confidence: 87%

Effect of baricity of intrathecal Bupivacaine on surgical environment in Urological procedures – A Comparative Study

Wilson

Kadar

2015

Int Jour of Biomed Res

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A comparative study was done with intrathecal bupivacaine of two different baricities. viz., isobaric 0.25% and hyberbaric 0.50%. The study was done in patients who underwent urological procedures. Surgical environment was compared in both groups. Surgeons were satisfied with surgical environment in both groups. Patients were satisfied with anaesthesia in both the groups. No complications were noted in both groups though all were elderly patients. Isobaric bupivacaine had a slower onset of level of block but produced an intense sensory and motor blockade, like hyperbaric bupivacaine. Height of analgesia and the duration of motor and sensory block were similar between the two groups, probably because the mass of bupivacaine injected was the same. Thus, we conclude that the mass of the drug is more important than the concentration in determining the surgical environment.

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Section: Duration Of Blockcontrasting

confidence: 87%

Effect of baricity of intrathecal Bupivacaine on surgical environment in Urological procedures – A Comparative Study

Wilson

Kadar

2015

Int Jour of Biomed Res

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“…There are numerous benefits of using opioids with local anesthetics for spinal vs systemic opioids in the perioperative period:  Superior analgesia with shorter time to ambulation  Fewer pulmonary complications  Earlier return of bowel function  Earlier hospital discharge rates A decreased stress response As plain solutions are in fact, slightly hypobaric (specific gravity 1.004 at 20ºC and 0.998 at 37ºC) compared to CSF (specific gravity 1.0063-1.0075, at 25ºC), it was found that the sitting position would result in a greater cephalad spread. 20 Under controlled clinical conditions, for example, Axelsson et al 8 found that decreasing the volume injected to 2.0 ml significantly decreased the level of anesthesia to T10-11 level, but that a further decrease in volume to 1.5ml was not associated with a further decrease in level of anesthesia. They compared 1.5ml, 2ml, 3ml and 4ml instilled intrathecally in 40 patients undergoing urological surgery under spinal anaesthesia.…”

Section: Discussionmentioning

confidence: 99%

Study on Comparing Intrathecal Hyperbaric Bupivacaine and Isobaric Bupivacaine In Common Surgical Procedures without Adjunct

Raushan¹

2014

IOSRJDMS

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“…[1][2][3][4] Nevertheless, recent studies using lidocaine solutions injected in the lateral decubitus position have produced controversial results. Toft et al compared 80 mg isobaric lidocaine solution (2%, 4 ml) with80 mg hyperbaric lidocaine solution (5%,1.3ml) and found no difference in the cephalic spread of the sensory or motor block.…”

Section: Discussionmentioning

confidence: 99%

“…He found that concentration, volume, and baricity had no effect on the cephalad spread of the block. Other studies using bupivacaine [1][2][3][4] found that cephalad spread was greater by an average of two dermatomes when a HB formulation was used. Unlike Bengtsson's experiment, the subjects were injected in the lateral decubitus position and not the sitting position.…”

Section: Discussionmentioning

confidence: 99%

Comparison of differential blockade during spinal anesthesia using isobaricvs hyperbaric lidocaine 2%

Jankowska¹,

Veillette

2000

Can J Anesth/J Can Anesth

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Purpose: To compare the extent of the sensory, motor and sympathetic block produced by a single dose of 60 mg lidocaine at the same concentration (2%) and volume but at different baricity injected intraspinally.Method: In a randomised double blind study, 40 ASA I -II patients were scheduled for elective surgery (orthopedic, urologic, peripheral vascular and lower digestive procedure). They were divided in two groups. Twenty patients received 60 mg lidocaine 2% in a hyperbaric solution and 20 received 60 mg lidocaine 2% in a isobaric solution. The levels of sensory (pinprick, ice) motor (Bromage scale) and sympathetic blockade (galvanometry, cutaneous blood flow, temperature) were measured at 0, 5, 10, 15, 20 and 30 min.Results: There were no differences between the groups with regard to maximal height of sympathetic block, sensory level to pinprick: T 5 ± 2.4 for isobaric group, T 6 ± 3.6 for hyperbaric group or to cold: T 3 ± 2.3 for isobaric group, T 4 ± 2.7 for hyperbaric group. Hyperbaric lidocaine 2% produced a more pronounced sensory (pinprick, ice) and motor block on the dependant than on the non-dependant side. Conclusion:The baricity of 60 mg lidocaine injected intraspinally in the lateral decubitus position did not influence the cephalad spread of sensory or sympathethic blockade. In the hyperbaric group, the dependent side showed a more pronounced sensory (pinprick, ice), and motor block.Objectif : Comparer l'étendue du bloc sensitif, moteur et sympathique d'une dose de 60 mg de lidocaïne 2 % à baricité différente, administrée en injection intrarachidienne, en décubitus latéral.Méthode : Quarante patients ASA I-II, dont l'opération était prévue, ont participé à une étude randomisée à double insu. Ils ont été répartis aléatoirement en deux groupes. Vingt patients ont reçu une anesthésie rachidienne avec 60 mg de lidocaïne isobare à 2 %, et 20 patients avec 60 mg de lidocaïne hyperbare à 2 %. Ont été mesurés sur une période de 30 min (0, 5, 10, 20, 30 min): l'expansion du bloc sympathique (galvanométrie, étude du flot vasculaire -Doppler -et prise de température aux extrémités), du bloc sensitif (aiguille et glace, côtés gauche et droit) ainsi que l'intensité du bloc moteur (gauche et droit). Une différence statistique de P < 0,05 était considérée significative.Résultats : Nous n'avons trouvé aucune différence significative intergroupe de diffusion céphalique de la sensibilité au froid et à l'aiguille. Les variations de température, de flot vasculaire, et de résistance cutanée étaient également comparables. Le bloc moteur était complet en 15 min chez tous les patients du groupe isobare, tandis que quelques patients n'avaient qu'un bloc partiel à droite (côté non dépendant) dans le groupe hyperbare, et ce, après 30 min.Conclusion : La baricité d'une solution de 60 mg de lidocaïne 2 % intrarachidienne n'influence pas le niveau céphalique sympathique, sensitif ou moteur en décubitus latéral. Cependant, un effet moteur plus marqué du côté déclive se dégage dans le groupe hyperbare.

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Effect of Baricity on Spinal Anaesthesia With Bupivacaine

Cited by 127 publications

References 1 publication

Effect of baricity of intrathecal Bupivacaine on surgical environment in Urological procedures – A Comparative Study

Effect of baricity of intrathecal Bupivacaine on surgical environment in Urological procedures – A Comparative Study

Study on Comparing Intrathecal Hyperbaric Bupivacaine and Isobaric Bupivacaine In Common Surgical Procedures without Adjunct

Comparison of differential blockade during spinal anesthesia using isobaricvs hyperbaric lidocaine 2%

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