Intrathecal Bupivacaine in Humans

Malinovsky, Jean-Marc; Renaud, Geraldine; Corre, Pascal Le; Charles, Florence; Lepage, Jean-Yves; Malinge, M.; Cozian, A.; Bouchot, Olivier; Pinaud, M.

doi:10.1097/00000542-199911000-00016

Cited by 69 publications

(14 citation statements)

References 17 publications

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“…However, there are large inter individual variations in the total volume of cerebrospinal fluid. [9] and dilution does not significantly affect the spread of intrathecal anesthesia. [10] Finally, the major determinant for the spread of intrathecal anesthesia is the dose of local anesthetic injected Greene NM.…”

Section: Discussionmentioning

confidence: 99%

Comparison of efficacy and safety of ropivacaine with bupivacaine for intrathecal anesthesia for lower abdominal and lower limb surgeries

2013

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Background:A prospective randomized clinical study was conducted to study the efficacy and safety of ropivacaine with bupivacaine intrathecally for lower abdominal and lower limb surgeries.Material and Methods:70 patients aged between 18 to 65 years were randomized into two groups, n = 35 in each group. Group A received 3 ml of (0.5%) isobaric bupivacaine (15 mg) and Group B 3 ml of (0.75%) isobaric ropivacaine (22.5 mg). Spinal anesthesia procedure was standardized. Haemodynamic parameters, onset and duration of sensory and motor blockade, level achieved, regression and side effects were compared between the two groups.Results:Onset and regression of sensory blockade in ropivacaine group was faster with a P < 0.001 which was statistically significant. Onset of motor blockade was rapid in both the groups but duration of motor blockade was significantly shorter in ropivacaine group. Excellent analgesia, with no side effects and stable haemodynamics was noted in ropivacaine group.Conclusion:Hence ropivacaine was safe and equally effective as bupivacaine for lower abdominal and lower limb surgeries with early motor recovery, providing early ambulation.

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Section: Discussionmentioning

confidence: 99%

Comparison of efficacy and safety of ropivacaine with bupivacaine for intrathecal anesthesia for lower abdominal and lower limb surgeries

2013

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“…Many factors have been expected to influence the sensory block level: local anesthetics baricity, volume (local anesthetics concentration), and patient position during spinal anesthesia. In their study, Malinovsky et al54 tested six different preparations of 10 mg bupivacaine (from 2–10 mL isobaric or hyperbaric bupivacaine) and found that volume had no significant influence on either cephalad spread for either isobaric or hyperbaric bupivacaine. A greater maximal cephalad spread of anesthesia was obtained with diluted isobaric bupivacaine, but hypotensive episodes were more frequent with a low volume of isobaric bupivacaine.…”

Section: Perioperative Blood Pressure Controlmentioning

confidence: 99%

“…A greater maximal cephalad spread of anesthesia was obtained with diluted isobaric bupivacaine, but hypotensive episodes were more frequent with a low volume of isobaric bupivacaine. Malinovsky et al hypothesize that decreasing the local anesthetic concentration limited the concentration of local anesthetics penetrating the nerve 54. The effect of the patient’s position during spinal anesthesia has been well evaluated in obstetrics.…”

Section: Perioperative Blood Pressure Controlmentioning

confidence: 99%

Optimal perioperative management of arterial blood pressure

Lonjaret¹,

Lairez²,

Minville

et al. 2014

IBPC

132

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Perioperative blood pressure management is a key factor of patient care for anesthetists, as perioperative hemodynamic instability is associated with cardiovascular complications. Hypertension is an independent predictive factor of cardiac adverse events in noncardiac surgery. Intraoperative hypotension is one of the most encountered factors associated with death related to anesthesia. In the preoperative setting, the majority of antihypertensive medications should be continued until surgery. Only renin-angiotensin system antagonists may be stopped. Hypertension, especially in the case of mild to moderate hypertension, is not a cause for delaying surgery. During the intraoperative period, anesthesia leads to hypotension. Hypotension episodes should be promptly treated by intravenous vasopressors, and according to their etiology. In the postoperative setting, hypertension predominates. Continuation of antihypertensive medications and postoperative care may be insufficient. In these cases, intravenous antihypertensive treatments are used to control blood pressure elevation.

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“…Znojenje je imao jedan bolesnik (5%). Slične rezultate opisali su Hakana i saradnici [9].Tokom njihove studije, pri primeni manjih doza lokalnih anestetika, hipotenzija se javila kod tri (10,0%), a mučnina i povraćanje kod jednog (3,3%) bolesnika.…”

Section: Rezultatiunclassified

The effectivness and simpthoms of spinal anaesthesia depending on the influence of the applied local anaestetic

Jović¹

2016

Tim Med Glas

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Sažetak:Cilj studije bio je da se uporedi kvalitet spinalnog bloka, stanje bolesnika tokom spinalne anestezije i pojava neželjenih efekata kod bolesnika koji su intratekalno primili različite količine rastvora 0,5% levobupivakaina. Metode: Studijom je obuhvaćeno 40 bolesnika, American Society of Anaesthesiologists (ASA) I do IV, koji su, radi izvođenja hirurške intervencije, bili podvrgnuti spinalnoj anesteziji. Bolesnici su bili podeljeni u dve grupe: grupa A (grupa koja je primila veći volumen) i grupa B (grupa koja je primila manji volumen). Monitoring je obuhvatao kontinuirano praćenje EKG-a, srčane frekvence, krvnog pritiska i saturacije kiseonikom. Rezultati: Prospektivnom studijom obuhvaćeno je 40 bolesnika, 24 (60%) muškarca i 16 (40%) žena. Među grupama nije bilo statistički značajne razlike prema godinama starosti i ASA statusu bolesnika. Nastanak i razvoj bradikardije bio je u statistički značajnoj korelaciji sa porastom doze aplikovanog lokalnog anestetika (p<0,001). Hipotenzija, bledilo kože, znojenje i mučnina opisani su samo u grupi bolesnika koji su primili veće doze lokalnog anestetika. Nije nađena statistički značajna razlika u uspešnosti spinalnog bloka zavisno od doze aplikovanog leka. Zaključak: Među grupama nije nađena statistički značajna razlika dozne zavisnosti uspešnosti spinalnog bloka. Incidenca neželjenih efekata bila je srazmerna količini datog anestetika. Ključne reči:spinalna anestezija, levobupivakain, toksičnost. Summary:The aim of the present study was to compare the anaesthesia quality, patient comfort and complications during spinal anaesthesia in patients who received less volume of the local anaesthetic (1.5ml and 2.0 ml) and patients with higher volumes intrathecally injected local anaesthetic (3.5ml and 4.0 ml) 0.5 % solution levobupivacaine. Materials and methods: The study involved 40 patients, ASA I to IV who were scheduled to have elective surgery with spinal anaesthesia. The patients were divided in two groups: Group A (the group received higher volume) and Group B (the group received less volume). The heart rate, non-invasive blood pressure and SpO2 were recorded before spinal anaesthesia and on 5 minutes during the surgery. Results: There were no significant differences between the two groups with respect to age and ASA patient status. The onset and progress of Bradycardia was in a significant statistical correlation with the dose of the local anaesthetic (p<0,001). The complications and side effects of spinal anaesthesia techniques, such as nausea, vomiting, headache were frequentl in the group with higher dose of local anaesthetic. Conclusion: There were no statistically significant discrepancies related to the success of the spinal block with respect to the dose of the applied anaesthetic. The incidence of sideeffects was proportional to the dose of the applied anaesthetic.

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Intrathecal Bupivacaine in Humans

Abstract: In this study, volume had no significant influence on either cephalad spread or duration of sensory blockade for either isobaric or hyperbaric bupivacaine. Time for offset of anesthesia was shorter with hyperbaric bupivacaine compared with isobaric solutions.

Cited by 69 publications

References 17 publications

Comparison of efficacy and safety of ropivacaine with bupivacaine for intrathecal anesthesia for lower abdominal and lower limb surgeries

Comparison of efficacy and safety of ropivacaine with bupivacaine for intrathecal anesthesia for lower abdominal and lower limb surgeries

Optimal perioperative management of arterial blood pressure

The effectivness and simpthoms of spinal anaesthesia depending on the influence of the applied local anaestetic

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