Spinal Anaesthesia with Hyperbaric 0.5 % Bupivacaine: Effects of Volume

Abstract

Different volumes (1.5, 2, 3 and 4 ml) of hyperbaric 0.5% bupivacaine (8% glucose) were compared in spinal anaesthesia for urological surgery in 40 patients. The blockade was given with the patient in the sitting position. Two minutes after the injection the patient was placed in the lithotomy position. The time required for maximum cephalad spread of analgesia was about 20 min for all volumes. The maximum cephalad spread was directly related to log volume of the local anaesthetic solution. The onset time for motor blockade of the lower limbs decreased and the frequency increased with increasing volume. Four ml produced complete blockade in all patients. The duration of analgesia increased with increasing volume: 3-4 ml produced analgesia at T8 for 1.5-2.5 h and at L1 for 2-3 h. With this volume, complete motor blockade was obtained for 1.5-2.5 h. Satisfactory surgical anaesthesia for transurethral resection was obtained with 3-4 ml of the local anaesthetic solution.

Home‐readiness after spinal anaesthesia with small doses of hyperbaric 0.5% bupivacaine

“…Although the sensory and motor block after 1 or 2 ml hyperbaric bupivacaine recovered within a reasonable time for day-case surgery, in some patients recovery of the ability to void was delayed to an undesirable extent. [6][7][8]. The use of bupivacaine in spinal anaesthesia is rarely followed by transient neurological symptoms [9].…”

“…After the recommendations of de Jong [4] and Sjöström & Bläss [5], we have abandoned the use of hyperbaric 5% lignocaine for spinal anaesthesia until the clinical significance of transient neurological symptoms are resolved. Hyperbaric 0.5% bupivacaine causes reliable spinal block of dosedependent duration [6][7][8]. The use of bupivacaine in spinal anaesthesia is rarely followed by transient neurological symptoms [9].…”

Spinal anaesthesia with lidocaine 2% for Caesarean section

“…12 The duration of motor block was also correlated with the dose of lidocaine injected, in agreement with the previous studies performed with isobaric lidocaine 12 and bupivacaine. [19][20][21] Hypotension was noted in 10% of the patients and these were the patients with higher mean maximum spread of analgesia. Nausea and vomiting was also common in these patients.…”

Comparison of intrathecal sufentanil and hyperbaric bupivacaine with intrathecal hyperbaric bupivacaine for caesarean section

“…8 From the studies of Sundnes et al and Axelsson et al we can conclude that by reducing the dose of local anesthetic, the cephalad spread, degree of motor block and duration of motor block can be decreased. 9,10 The addition of sufentanil enhances the somatic analgesia thus achieving similar peak sensory levels with smaller dose of local anaesthetic thus induction to baby delivery time can be reduced. The mean duration of analgesia was significantly prolonged in group BS as compared to group B wherein the rescue analgesic was required earlier (p<0.05).…”