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Cold and Touch Stimulation For The Assessment of Block Level At Spinal Anesthesia

Year 2007, Volume: 12 Issue: 1, 53 - 55, 01.02.2007

Abstract

Objective: To determine the dermatomal level of sensory block after spinal anesthesia traditionally used method is pinprick test. Pinprick test is an invasive and painful method. We aimed to compare the dermatomal levels of sensory block determined by noninvasive simple tests touch and cold sense loss with routinely used invasive pinprick stimulation test in clinical practice. Materials and Methods: Spinal anesthesia was performed with the patients placed in the sitting position by injecting 1 mg kg-1 2 % lidocaine intrathecally through a 22 gauge needle inserted at the L3-4 interspace. Spinal anesthesia was performed with the patients 1 2 % lidocaineplaced in the sitting position by injecting 1 mg kg intrathecally through a 22 gauge needle inserted at the L3-4 interspace. The levels of block were assessed at 5th and 20th min after the spinal injection. Needle for pinprick, a piece of cotton for touch and ice in a finger of surgical glove for cold sensory were used. Results: No significant difference was observed between the dermatomal level of loss of pinprick sense and the dermatomal level of loss of either touch sense or cold sense at 5th min. However at 20th min the dermatomal level of loss of touch sense was significantly lower than the dermatomal level of loss of pinprick and cold sensations (p

References

  • Curatolo M, Petersen-Felix S, Arendt-Nielsen L. Sensory assessment analgesia in humans: A review of methods and applications. Anesthesiology 2000; 93: 1517-1530.
  • Ikuta Y, Shimoda O, Ushijima K, Terasaki H. Skin vasomotor reflex as an objective indicator to assess level of regional anesthesia. Anesth Analg 1998; 86: 336-340.
  • Fassoulaki A, Sarantopoulos C, Zotou M, Karabinis G. Assessment of the level of sensory block after subarachnoid anesthesia using a pressure palpatori. Anesth Analg 1999; 88: 398-401.
  • Shah J, Owen-Smith O, Coley S, Jeyapalan I, Atcheson R, May A. The pricking pain roller for assessment of sensory block after spinal anesthesia. Int Monit Reg Anaesth 1998; 10: 16.
  • Bourne TM, Campbell F, Mushambi MC, May AE. Patients’ assessment of sensory levels during extradural anesthesia in labor. Int J Obstet Anaesth 1997; 6: 239-241.
  • Hughes JC, Harmer M: A new gas jet method for the assessment of sensory block after spinal anaesthesia. Anaesthesia 1998; 53: 197-200.
  • Rocco AG, Raymond SA, Murray E, Dhingra U, Freiberger D. Differential spread of blockade of touch, cold, and pinprick during spinal anesthesia. Anesth Analg 1985; 64: 917-923.
  • Lui S, Kopacz DJ, Carpenter RL. Quantitative assessment of differential sensory nevre block after lidocaine spinal anesthesia. Anesthesiology 1995; 82: 60-63.
  • Sakura S, Sakaguchi Y, Shinzawa M, Hara K, Saito Y. The assessment of dermatomal level of surgical anesthesia after spinal tetracaine. Anesth Analg 2000; 90: 1406-1410.
  • Shah J, Ayorinde BT, Rowbotham DJ, Buggy DJ. Warm air sensation for assessment of block after spinal anesthesia. Br J Anesth 2000; 84: 399-400.
  • Larson MD, Sessler DI, Ozaki M, McGuire J, Schroeder M. Pupillary assessment of block level during combined epidural/general anesthesia. Anesthesiology 1993; 79: 42-48.
  • Sakura S, Sumi M, Yamada Y, Kosaka YS. Quantitative and selective assessment of sensory block during lumbar epidural anaesthesia with 1% or 2% lidocaine. Br J Anesth 1998; 81: 718- 722.
  • Russell IF. A comparison of cold, pinprick and touch for assessing the level of spinal block at caesarean section. Intern J Obstet Anesth 2004; 13: 142-152.
  • Kabul Tarihi: 29.09.2006

Spinal anestezide blok seviyesinin belirlenmesinde soğuk ve dokunma stimulasyonu

Year 2007, Volume: 12 Issue: 1, 53 - 55, 01.02.2007

Abstract

Amaç: Spinal anesteziden sonra duyusal bloğun dermatomal seviyesini belirlemek için geleneksel olarak pinpirick testi kullanılır. Pinpirick testi invazif ve ağrılı bir yöntemdir. Klinik pratikte rutin olarak kullanılan invazif pinpirick uyarısı ile nonivazif basit dokunma ve soğuk duyu kaybı testleriyle belirlenmiş duyusal blok dermatomal seviyelerini karşılaştırmayı amaçladık. Gereç ve Yöntem: Alt abdominal veya alt ekstremite cerrahi geçiren, 32 yetişkin erkek hasta (ASAI-II, 45±8 yaşlarında) bu randomize, prospektif çalışmaya alındı. Oturur pozisyonda, 1 mg kg-1 %2'lik lidokainin 22 gauge iğne ile L3-4 aralıktan enjeksiyonuyla spinal anestezi gerçekleştirildi. Spinal enjeksiyondan sonra 5. ve 20. dak.'da blok seviyeleri değerlendirildi. Pinpirick için iğne, dokunma duyusu için pamuk parçası ve soğuk duyusu için bir cerrahi eldiven parmağına konulan buz kullanıldı. Bulgular: Pinpirick duyu kaybının dermatomal seviyesi ile dokunma veya soğuk duyu kaybının dermatomal seviyeleri arasında 5. dak.'da anlamlı fark bulunmadı. Ancak, 20. dak'da dokunma duyu kaybının dermatomal seviyesi pinpirick ve soğuk duyu kaybının dermatomal seviyelerinden anlamlı derecede daha düşüktü (p

References

  • Curatolo M, Petersen-Felix S, Arendt-Nielsen L. Sensory assessment analgesia in humans: A review of methods and applications. Anesthesiology 2000; 93: 1517-1530.
  • Ikuta Y, Shimoda O, Ushijima K, Terasaki H. Skin vasomotor reflex as an objective indicator to assess level of regional anesthesia. Anesth Analg 1998; 86: 336-340.
  • Fassoulaki A, Sarantopoulos C, Zotou M, Karabinis G. Assessment of the level of sensory block after subarachnoid anesthesia using a pressure palpatori. Anesth Analg 1999; 88: 398-401.
  • Shah J, Owen-Smith O, Coley S, Jeyapalan I, Atcheson R, May A. The pricking pain roller for assessment of sensory block after spinal anesthesia. Int Monit Reg Anaesth 1998; 10: 16.
  • Bourne TM, Campbell F, Mushambi MC, May AE. Patients’ assessment of sensory levels during extradural anesthesia in labor. Int J Obstet Anaesth 1997; 6: 239-241.
  • Hughes JC, Harmer M: A new gas jet method for the assessment of sensory block after spinal anaesthesia. Anaesthesia 1998; 53: 197-200.
  • Rocco AG, Raymond SA, Murray E, Dhingra U, Freiberger D. Differential spread of blockade of touch, cold, and pinprick during spinal anesthesia. Anesth Analg 1985; 64: 917-923.
  • Lui S, Kopacz DJ, Carpenter RL. Quantitative assessment of differential sensory nevre block after lidocaine spinal anesthesia. Anesthesiology 1995; 82: 60-63.
  • Sakura S, Sakaguchi Y, Shinzawa M, Hara K, Saito Y. The assessment of dermatomal level of surgical anesthesia after spinal tetracaine. Anesth Analg 2000; 90: 1406-1410.
  • Shah J, Ayorinde BT, Rowbotham DJ, Buggy DJ. Warm air sensation for assessment of block after spinal anesthesia. Br J Anesth 2000; 84: 399-400.
  • Larson MD, Sessler DI, Ozaki M, McGuire J, Schroeder M. Pupillary assessment of block level during combined epidural/general anesthesia. Anesthesiology 1993; 79: 42-48.
  • Sakura S, Sumi M, Yamada Y, Kosaka YS. Quantitative and selective assessment of sensory block during lumbar epidural anaesthesia with 1% or 2% lidocaine. Br J Anesth 1998; 81: 718- 722.
  • Russell IF. A comparison of cold, pinprick and touch for assessing the level of spinal block at caesarean section. Intern J Obstet Anesth 2004; 13: 142-152.
  • Kabul Tarihi: 29.09.2006
There are 14 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Azize Beştaş This is me

Ömer Lütfi Erhan This is me

Mehmet Nihat Okuducu This is me

Levent Avcı This is me

Mehmet Akif Yaşar This is me

Publication Date February 1, 2007
Published in Issue Year 2007 Volume: 12 Issue: 1

Cite

APA Beştaş, A., Erhan, Ö. L., Okuducu, M. N., Avcı, L., et al. (2007). Spinal anestezide blok seviyesinin belirlenmesinde soğuk ve dokunma stimulasyonu. Fırat Tıp Dergisi, 12(1), 53-55.
AMA Beştaş A, Erhan ÖL, Okuducu MN, Avcı L, Yaşar MA. Spinal anestezide blok seviyesinin belirlenmesinde soğuk ve dokunma stimulasyonu. Fırat Tıp Dergisi. February 2007;12(1):53-55.
Chicago Beştaş, Azize, Ömer Lütfi Erhan, Mehmet Nihat Okuducu, Levent Avcı, and Mehmet Akif Yaşar. “Spinal Anestezide Blok Seviyesinin Belirlenmesinde soğuk Ve Dokunma Stimulasyonu”. Fırat Tıp Dergisi 12, no. 1 (February 2007): 53-55.
EndNote Beştaş A, Erhan ÖL, Okuducu MN, Avcı L, Yaşar MA (February 1, 2007) Spinal anestezide blok seviyesinin belirlenmesinde soğuk ve dokunma stimulasyonu. Fırat Tıp Dergisi 12 1 53–55.
IEEE A. Beştaş, Ö. L. Erhan, M. N. Okuducu, L. Avcı, and M. A. Yaşar, “Spinal anestezide blok seviyesinin belirlenmesinde soğuk ve dokunma stimulasyonu”, Fırat Tıp Dergisi, vol. 12, no. 1, pp. 53–55, 2007.
ISNAD Beştaş, Azize et al. “Spinal Anestezide Blok Seviyesinin Belirlenmesinde soğuk Ve Dokunma Stimulasyonu”. Fırat Tıp Dergisi 12/1 (February 2007), 53-55.
JAMA Beştaş A, Erhan ÖL, Okuducu MN, Avcı L, Yaşar MA. Spinal anestezide blok seviyesinin belirlenmesinde soğuk ve dokunma stimulasyonu. Fırat Tıp Dergisi. 2007;12:53–55.
MLA Beştaş, Azize et al. “Spinal Anestezide Blok Seviyesinin Belirlenmesinde soğuk Ve Dokunma Stimulasyonu”. Fırat Tıp Dergisi, vol. 12, no. 1, 2007, pp. 53-55.
Vancouver Beştaş A, Erhan ÖL, Okuducu MN, Avcı L, Yaşar MA. Spinal anestezide blok seviyesinin belirlenmesinde soğuk ve dokunma stimulasyonu. Fırat Tıp Dergisi. 2007;12(1):53-5.