Low dose hyperbaric bupivicaine injected at T12–L1 provides adequate anesthesia with stable hemodynamics for elderly patients undergoing TURP

Abdelmonem, Amr

doi:10.1016/j.egja.2011.04.001

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Only eight in isobaric group and seven in hyperbaric group patient exhibited the predicted level of block at T 10 . This result is consistent with the study conducted by Abdelmomen et al 14 . The classic isobaric spinal anaesthetic provides a block that is dense in lower thoracic, lumber and sacral areas and is ideally suited to perineal, urologic and lower extremity surgery.…”

Section: Discussionsupporting

confidence: 83%

Effects Of Isobaric Bupivacaine In Endoscopic Urological Surgeries Under Spinal Anaethesia

Hussain

Mallick

2012

J. Armed Forces Med. Coll.

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Introduction: Isobaric bupivacaine is not routinely practiced as a subarachnoid block, though it may be used as an alternative to traditional hyperbaric solution with less complications and a good operative condition in endoscopic urologic surgery. Objective: This prospective randomized study was conducted over a period of 18 months to evaluate the effects of isobaric bupivacaine with low dose fentanyl in endoscopic urologic surgeries under spinal anaesthesia. Methods: Two equally sized groups (n=60) of male patients were randomly selected and studied for routine endo-urological surgeries under subarachnoid block. One group received 0.5% hyperbaric bupivacaine (HBF) and the other group received 0.5% isobaric bupivacaine (IBF). In both groups bupivacaine was mixed with low dose fentanyl (10 microgram) and 1 ml distilled water. Non-invasive blood pressure, heart rate, SpO2, levels of sensory and motor blockade were recorded frequently. Complications of intrathecal block (if developed)were also recorded and treated. Results: The mean operation time was 49.9±9.55 and 50.10.10±7.98 minutes in HBF and IBF groups respectively and the difference was not statistically significant (p>0.05). The mean time to request for first analgesic was 402.50 ± 37.21 and 288.90±25.22 minutes in HBF and IBF groups respectively and the difference was statistically significant (p<0.001). There was no difference in the level of sensory block and total amount of fluid infused (p>0.05). Base line heart rate and blood pressure of the two studied groups were similar. After the subarachnoid block blood pressure reduced significantly in both the groups (p<0.001) but remained within the acceptable level for the surgery. No significant differences in complications like shivering, nausea, vomiting, hypotension, bradycardia were observed in the groups. Conclusion: Intrathecal isobaric bupivacaine with low dose fentanyl may be used as an alternative to traditional hyperbaric bupivacaine for endoscopic urologic surgeries with less side effects related to intrathecal opioid.

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Section: Discussionsupporting

confidence: 83%