Subarachnoid Blockade With Bupivacaine

Cummings, G.C.; Bamber, D. B.; Edström, H. H.; Rubin, Anthony P.

doi:10.1093/bja/56.6.573

Cited by 29 publications

(9 citation statements)

References 17 publications

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“…Two patients in whom a higher block was not reached in the second anaesthetic had normal BMI values. It has been shown that, when hyperbaric 0.5% bupivacaine is injected with the patient in the horizontal position, the height of block is increased in comparison with the same dose of plain bupivacaine [13][14][15][16]. However, our data do not support these findings.…”

Section: Discussioncontrasting

confidence: 99%

Prediction of the Spread of Repeated Spinal Anaesthesia With Bupivacaine

TUOMINEN¹,

PITKÄNEN²,

TAIVAINEN³

et al. 1992

British Journal of Anaesthesia

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We have studied in 56 patients the predictability of spread of repeated spinal anaesthesia in the same patient on the basis of a previous block. With plain 0.5% bupivacaine, prediction of the second block was accurate. A significantly higher or lower spread of analgesia than in the previous block was achieved when plain 0.5% bupivacaine was administered using a modified technique-sitting position or lower interspace, respectively. When hyperbaric 0.5% bupivacaine was injected instead of plain solution for the second block using a similar technique, no baricity-related correlation was found between the first and second blocks. Change in technique did not reduce interindividual variation in the spread of analgesia. We conclude that individual anatomical properties may play a more important role than, for example, baricity in subarachnoid distribution of a local anaesthetic solution.

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Section: Discussioncontrasting

confidence: 99%

Prediction of the Spread of Repeated Spinal Anaesthesia With Bupivacaine

TUOMINEN¹,

PITKÄNEN²,

TAIVAINEN³

et al. 1992

British Journal of Anaesthesia

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“…This is not in agreement with other studies [4,10,11], which found that isobaric bupivacaine produced a lower level of block. In our study the desired level of analgesia was T 10 , which could have been achieved with lesser mass of bupivacaine in both the groups because Suzuki et al [3] found that anaesthetic levels tended to increase with increasing dosage in both groups.…”

Section: Extent Of Sensory Blockcontrasting

confidence: 91%

“…Moller et al [4] and Cummings et al [11] reported that hyperbaric bupivacaine increased the height of block with decreased duration of block compared to isobaric bupivacaine.…”

Section: Review Of Literaturementioning

confidence: 99%

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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“…This may explain why the upper levels were the same in both groups, even though the hyperbaric solutions are expected to produce higher levels in supine position on a horizontal table. 9 Complete recovery of the motor block occurred in 2.5 hr with either form of bupivacaine. This is not very different from the recovery wich follows the injection of 2.5 ml lidocaine (50 mg) in the subarachnoid space, 1 and make 9.75 mg of either isobaric or hyperbaric bupivacaine compatible with ambulatory surgery.…”

Section: Resultsmentioning

confidence: 94%

Onset of spinal block is more rapid with isobaric than hyperbaric bupivacaine

Martin

Frigon

Chretien

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: To compare isobaric with hyperbaric 9.75 mg bupivacaine injected intrathecally, and to evaluate the effects of subsequent injection of lidocaine 2% into the epidural space.Methods: Patients in group 1 (n=30) received isobaric 9.75 mg bupivacaine and in group 2 (n=30) hyperbaric 9.75 mg bupivacaine injected into the subarachnoid space in a combined spinal-epidural technique. They were undergoing urological, gynecological, orthopedic, gastro-intestinal or vascular surgery. Using a double blind technique, the followings parameters were measured: cutaneous analgesia to pinprick, motor blockade, time for two segment regression, time for complete regression of the motor block, quality of anesthesia. In 12 patients the effect of epidural injections of 3 ml lidocaine 2% was observed.Results: Motor and sensory block developed more rapidly (five minutes) in the isobaric group ( P < 0.05) . Maximum upper level (T7 ± 2 ), two-segment regression (52 min in both groups), motor recovery (160 vs 157 min), and quality of anesthesia did not differ between the two groups. Thirty nine epidural injections of 3 ml lidocaine 2% were given in 12 patients 10 min after spinal injection, 28 were in the hyperbaric group (P < 0.05). Twenty six of the epidural injections produced an increase in sensory block of 0 or 1 dermatome, and 13, of 2 or more. Conclusion:The block developed more rapidly in the isobaric group, but both isobaric and hyperbaric 9.75 mg bupivacaine produced adequate upper levels of analgesia for surgery. The effect of epidural injections of 3 ml lidocaine 2% was usually minimal.Objectif : Comparer 9,75 mg de bupivacaïne isobare et hyperbare injectés en sous-arachnoïdien, et évaluer l'effet, quand nécessaire, de la lidocaïne 2 % injectée subséquemment dans l'espace épidural.Méthode : Les patients du groupe 1 (n=30) ont reçu 9,75 mg de bupivacaïne isobare et ceux du groupe 2 (n=30) 9,75 mg de bupivacaïne hyperbare en injection sous-arachnoïdienne selon une technique combinée rachi-épidurale. Des interventions chirurgicales urologiques, gynécologiques, orthopédiques, gastro-intestinales et vasculaires ont été faites. En utilisant une technique de double insu, on a mesuré les paramètres suivants : analgésie cutanée à la piqûre, bloc moteur, temps de régression de 2 niveaux, temps de régression complète du bloc moteur, qualité d'anesthésie. Chez 12 patients qui ont eu besoin d'injections épidurales de 3 ml de lidocaïne 2 %, l'effet de l'injection a été observé.Résultats : Les blocs moteur et sensitif se sont développés plus rapidement (5 min) dans le groupe isobare (P < 0,05). Les niveaux supérieurs d'analgésie (D7 ± 2), les temps de régression de 2 segments (52 min), la récupération motrice (160 vs 157 min), et la qualité de l'anesthésie ont été similaires. Trente-neuf injections épidu-rales de 3 ml de lidocaïne 2 % ont été faites chez 12 patients, 10 min après l'injection sous-arachnoïdienne. Vingthuit des réinjections l'ont été dans le groupe hyperbare (P < 0,05); vingt-six ont produit une augmentation de 0 ou 1 de...

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Subarachnoid Blockade With Bupivacaine

Cited by 29 publications

References 17 publications

Prediction of the Spread of Repeated Spinal Anaesthesia With Bupivacaine

Prediction of the Spread of Repeated Spinal Anaesthesia With Bupivacaine

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

Onset of spinal block is more rapid with isobaric than hyperbaric bupivacaine

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