Effects of unilateral spinal anesthesia with low dose bupivacaine and bupivacaine-fentanyl combination on recovery

Abstract

Objectives: Our aim was to compare unilateral spinal anesthesia produced by 6 mg hyperbaric bupivacaine or 4 mg hyperbaric bupivacaine plus 10 µg fentanyl for day-case arthroscopic knee surgery. Material and methods: In this study we evaluated hemodynamic effects, block levels, and recovery characteristics. After approval of Institutional Ethics Committee, ASA I-II, 42 patients were enrolled into the study. Patients were randomly allocated in two groups. Group I (n=22) 6 mg hyperbaric bupivacaine+10µg fentanyl, group II (n=22) 4 mg hyperbaric bupivacaine+10µg fentanyl. The patients were applied standard monitoring, and hemodynamic parameters were recorded. Then spinal anesthesia was performed with the patient lateral decubitis position, using a 25 G Quincke spinal needle at the L3-4 intervertebral space. Parameters below were recorded for each patient: hemodynamic, time to reach to level of T12 dermatome, maximum sensory level, motor block levels and recovery characteristics level of motor block, level of sensory block, time to reach T12 dermatome. Results: Demographic and hemodynamic variables were not different between groups (p>0.05). Although level of sensory block, and time to reach T12 dermatome were not different (p>0.05), level of motor block, ambulation time and time to discharge were significantly longer in Group I than Group II (p

Keywords

• Arthroscopy, spinal anesthesia, bupivacaine, fentanyl, recovery

Tek taraflı spinal anestezide düşük doz bupivakain ve bupivakain-fentanil kombinasyonunun derlenmeye etkisi

Öz

Amaç: Çalışmada, tek taraflı spinal anestezi altında, elektif artroskopik diz cerrahisi uygulanan hastalarda, 6 mg hiperbarik bupivakain (HB) ile 4 mg hiperbarik bupivakaine eklenen 10 µg fentanil (F) ‘in etkilerini karşılaştırmayı amaçladık. Gereç ve yöntem: Yaşları 18-60 yıl arası ASA 1-2, 42 hasta etik kurul onayı alındıktan sonra çalışmaya dahil edildi. Hastalar rastgele iki gruba ayrıldı. Grup I (n=22) 6 mg HB+10µg F (1.4 mL) ve Grup II (n=22) 4 mg HB+10µg F (1 mL) olarak belirlendi. Hastalara standart monitörizasyon uygulandı ve hemodinamik parametreler kaydedildi. Spinal anestezi, lateral dekübit pozisyonunda, 25 G Quincke spinal iğne ile L3-L4 aralıktan spinal mesafeye girilerek uygulandı. Bu çalışmada hemodinamik etkiler, blok seviyeleri, derlenme karakteristiklerini değerlendirdik. Her hasta için aşağıdaki parametreler kaydedildi: Her iki grubun hemodinamik değişiklikleri (HD), T12 dermatoma ulaşma zamanı (T12D), maksimum duyusal blok (MDB), motor blok seviyeleri (MBS) ve derlenme parametreleri. Bulgular: Demografik veriler, hemodinamik değişiklikler gruplar arasında farklı değildi (p>0.05). Duyusal blok seviyesi ve T12 dermatoma ulaşma seviyeleri her iki grupda farksız olmasına (p>0.05) karşın, motor blok seviyesi, ambulasyon zamanı ve taburculuk süresi Grup I\'de Grup II\'ye göre istatistiksel olarak anlamlı olarak uzun bulundu (p0.05). Sonuç: Günübirlik artroskopik diz cerrahisi anestezisinde 6 mg HB+10 µg F ile karşılaştırıldığında, 4 mg HB+10µg F\'in sağladığı derlenme karakteristiklerinden dolayı üstün olabilir.

Anahtar Kelimeler

• artroskopi, spinal anestezi, bupivakain, fentanil, derlenme

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