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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2004 March;70(3):91-6

language: English, Italian

Spi­nal anesthe­sia ­using hyper­bar­ic 0.75% vs hyper­bar­ic 1% bupiv­a­caine: a dou­ble ­blind com­par­i­son

Iannuzzi E. 1, Iannuzzi M. 2, Viola G. 2, Chiefari M. 1

1 2nd Ser­vice of Anesthe­sia Depart­ment of Anes­the­sio­log­i­cal Sur­gi­cal and Emer­gen­cy Sci­enc­es The Sec­ond Uni­ver­sity of ­Naples, ­Naples, Ita­ly
2 Post Grad­u­ate ­School of Anesthe­sia and Inten­sive ­Care Med­i­cine The Sec­ond Uni­ver­sity of ­Naples, ­Naples, Ita­ly


Aim. The aim of ­this ­study was to com­pare the anes­thet­ic ­effects, poten­cy and post­op­er­a­tive out­come of 0.75% and 1% con­cen­tra­tions of hyper­bar­ic bupiv­a­caine in selec­tive spi­nal anes­the­sia.
Meth­ods. We ­enrolled 40 ­patients in a dou­ble ­blind fash­ion in 2 ­groups (A= 0.75% bupiv­a­caine; B= 1% bupiv­a­caine). Dem­o­graph­ic ­data ­were respec­tive­ly for ­Groups A and B: age 40.6±16 and 67±16, ­weight 74±14.4 and 68±10.2; sex 10M/10F and 6M/14F ; ASA I-II 11/9 and 14/6. All ­patients ­received 11.25 mg bupiv­a­caine. In all cas­es a 27G Whit­a­cre nee­dle was intro­duced at L1-L2 , L2- L3, L3-L4 intro­duced ­with a mid­line ­approach. ­Time to ­onset and off­set of sen­si­tive and ­motor ­block, der­mat­o­mer­ic exten­sion non inva­sive ­blood pres­sure, ­heart ­rate, ephed­rine ­dose, deam­bu­la­tion ­time, diu­re­sis ­time and ­request for sup­ple­men­tal anal­ge­sia ­were record­ed.
­Results. No sta­tis­ti­cal­ly sig­nif­i­cant dif­fer­enc­es ­between the 2 ­groups for dem­o­graph­ic ­data ­were ­found. ­Group B ­revealed a fast­er ­onset and a ­more ade­quate der­mat­o­mer­ic exten­sion (4.1±0.8 min vs 6.5±1.2 min). ­Both con­cen­tra­tions guar­an­teed ­good hemo­dy­nam­ic stabil­ity. ­Motor off­set ­times ­were 115.8±145 min and 142±4.8 min respec­tive­ly in ­groups A and B. Sen­si­tive off­set ­times ­were 197.5±12 min and 168±5.2 min respec­tive­ly in ­groups A and B. No sta­tis­ti­cal­ly rel­e­vant dif­fer­enc­es ­were ­noticed for intra­op­er­a­tive Brom­age, sen­si­tive ­block or for post­op­er­a­tive ­motor and sen­si­tive off­set ­time, diu­re­sis ­time and deam­bu­la­tion ­time. ­There are no advan­tag­es of 1% hyper­bar­ic bupiv­a­caine ­over 0.75% for selec­tive spi­nal anes­the­sia, ­while sev­er­al dis­ad­van­tag­es pre­sent­ed short­er dura­tion of post­op­er­a­tive anal­ge­sia and high­er in­cidence of head­ache.

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