BibTex RIS Cite

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

Year 2011, Volume: 2 Issue: 1, 22 - 29, 01.03.2011
https://doi.org/10.5799/ahinjs.01.2011.01.0205

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

References

  • Morgan GE, Mikhael MS Clinical Anesthesiology, second edition, Appleton & Lange Publisher, Stanford, Connecticut, 1996. S: 211-229.
  • Kayhan Z. Ayaktan Yapılacak Girişimlerde Anestezi. Klinik Anestezi, 2. Baskı, Logos Yayıncılık, 1997. S:604606.
  • Ben-David B, Solomon E, Levin H, Admoni H, Goldik Z. Intrathecal fentanyl with small dose diluete bupivacaine. Anesth Analg 1997;85:560-565.
  • Ben-David B, Maryanovsky M, Gurevitch A, Lucyk C, Solosko D, Frankel R, Volpin G, DeMeo PJ. A comparison of minidose lidocaine-fentanyl and conventional dose lidocaine spinal anesthesia. Anesthesia Analgesia 2000;91: 865-870.
  • White PF (2000) Outpatient surgery. Anesthesia, fifth edition, Miller RD (Ed), Churchill Livingstone, New York, p: 2213-2240.
  • Kuusniemi KS, Pihlajamaki KK, Pitkanen MT, Korkella JE. Low dose bupivacaine: A comparison of hipobaric and near isobaric solution for arthroscopic surgery of the knee. Anaesthesia 1999;54: 540-545.
  • Casati A, Albertini A. Unilateral spinal block Technical issues. Europen Society of Regional Anesthesia, 2000, p: 208-11.
  • Casati A, Fanelli G, Cappalleri G, Borghi B, Cedrati V, Torri G. Low dose hyperbaric bupivacaine for unilateral anaesthesia. Can J Anaesth 1998;45: 850-4.
  • Casati A. Unilateral spinal block: Highlight in Regional Anaesthesia, XIX Annual ESRA Congress Rome, September 20 - 23, 2000.
  • Cappelleri G, Casati A, Farelli G, Borghi B, Anelati D, Berti M, Albertin A. Unilateral spinal anesthesia or com bined sciatic-femoral nerve block for day case knee arthroscopy. A prospective randomized comparison. Minerva Anesthesiol 2000;66:131-136.
  • Esmaoglu A, Boyacı A, Ersoy O, Güler G, Talo R, Tercan E. Unilateral spinal anaesthesia with hyperbaric bupivacaine. Acta Anaesthesiol Scand 1998; 42: 1083-1087.
  • Şentürk M, Akçora D. Kombine spinal-epidural anestezi yöntemi ile unilateral spinal anestezi uygulamaları. Ağrı dergisi, 2001;13:41-45.
  • Ben-David B, Levin H, Solomon E, Admoni H, Vaida S. Spinal bupivacaine in ambulatory surgery: the effect of saline dilution. Anesth Analg, 1996;83: 716-720.
  • Borghi B, Stagni F, Bugamelli S, et al. Unilateral spinal block for outpatient knee arthroscopy: A Dose-Finding Study. J Clin Anesth 2003;15:351-356.
  • Gentili ME. Unilateral spinal anesthesia with a combination of hyperbaric bupivacaine and clonidine. Cah Anesthesiol 1993;41: 291-294.
  • Kuusniemi KS, Pihlajamaki KK, Pitkanen MT, Korkeila JE. Low dose bupivacaine: A comparison of hipobaric and near isobaric solution for arthroscopic surgery of the knee. Anaesthesia 1999;54: 540-545.
  • Valanne JV, Korhonen AM, Jokela RM, Ravaska P, Korttila KK. Selective spinal anesthesia: A comprasion of hyperbaric bupivacaine 4 mg versus 6 mg for outpatient knee arthroscopy. 2001; 93:1377-1379.
  • Mulroy MF, Larkin KL, Hodgson PS, Helman JD, Pollock JE, Liu SS. A comparison of spinal, epidural and general anesthesia for outpatient knee arthroscopy. Anesth Analg 2000; 91: 860-864.
  • Wang C, Chakrabarti M K, Whitwam J G. Effects of intrathecal bupivacaine on nociceptive efferent but not on sympathetic efferent pathways in dogs. Anesthesiology 1993; 79:766-773.
  • Casati A, Fanelli G, Cappelleri G, Leoni A, Berti M, Aldegheri G, Torridoes G. Does speed of intratechal injection affect the distribution of 0.5% hyperbaric bupivacaine? Br J Anaesth 1998;81: 355-357.
  • Kallio H, Snall EV, Suvanto SJ, et al. Spinal hyperbaric ropivacain-fentanyl for day-surgery. Reg Anesth Pain Med 2005; 30:48-54
  • Veghadia H, McLeod DH, Mitchell GW, Merrick PM, Chilvers CR. Small dose hypobaric lidocaine-fentanyl spinal anesthesia for short duration outpatient laparoscopic optimal fentanyl dose. Anesth Analg 1997; 84:65-77.
  • Bearsley D, Holman S, Gannt R, et al. Transient neurologic deficit after spinal anesthesia: Local anesthetic maldistribution with pencil-point needles? Anesth Analg 1995; 81:314-320.

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

Year 2011, Volume: 2 Issue: 1, 22 - 29, 01.03.2011
https://doi.org/10.5799/ahinjs.01.2011.01.0205

Abstract

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.

References

  • Morgan GE, Mikhael MS Clinical Anesthesiology, second edition, Appleton & Lange Publisher, Stanford, Connecticut, 1996. S: 211-229.
  • Kayhan Z. Ayaktan Yapılacak Girişimlerde Anestezi. Klinik Anestezi, 2. Baskı, Logos Yayıncılık, 1997. S:604606.
  • Ben-David B, Solomon E, Levin H, Admoni H, Goldik Z. Intrathecal fentanyl with small dose diluete bupivacaine. Anesth Analg 1997;85:560-565.
  • Ben-David B, Maryanovsky M, Gurevitch A, Lucyk C, Solosko D, Frankel R, Volpin G, DeMeo PJ. A comparison of minidose lidocaine-fentanyl and conventional dose lidocaine spinal anesthesia. Anesthesia Analgesia 2000;91: 865-870.
  • White PF (2000) Outpatient surgery. Anesthesia, fifth edition, Miller RD (Ed), Churchill Livingstone, New York, p: 2213-2240.
  • Kuusniemi KS, Pihlajamaki KK, Pitkanen MT, Korkella JE. Low dose bupivacaine: A comparison of hipobaric and near isobaric solution for arthroscopic surgery of the knee. Anaesthesia 1999;54: 540-545.
  • Casati A, Albertini A. Unilateral spinal block Technical issues. Europen Society of Regional Anesthesia, 2000, p: 208-11.
  • Casati A, Fanelli G, Cappalleri G, Borghi B, Cedrati V, Torri G. Low dose hyperbaric bupivacaine for unilateral anaesthesia. Can J Anaesth 1998;45: 850-4.
  • Casati A. Unilateral spinal block: Highlight in Regional Anaesthesia, XIX Annual ESRA Congress Rome, September 20 - 23, 2000.
  • Cappelleri G, Casati A, Farelli G, Borghi B, Anelati D, Berti M, Albertin A. Unilateral spinal anesthesia or com bined sciatic-femoral nerve block for day case knee arthroscopy. A prospective randomized comparison. Minerva Anesthesiol 2000;66:131-136.
  • Esmaoglu A, Boyacı A, Ersoy O, Güler G, Talo R, Tercan E. Unilateral spinal anaesthesia with hyperbaric bupivacaine. Acta Anaesthesiol Scand 1998; 42: 1083-1087.
  • Şentürk M, Akçora D. Kombine spinal-epidural anestezi yöntemi ile unilateral spinal anestezi uygulamaları. Ağrı dergisi, 2001;13:41-45.
  • Ben-David B, Levin H, Solomon E, Admoni H, Vaida S. Spinal bupivacaine in ambulatory surgery: the effect of saline dilution. Anesth Analg, 1996;83: 716-720.
  • Borghi B, Stagni F, Bugamelli S, et al. Unilateral spinal block for outpatient knee arthroscopy: A Dose-Finding Study. J Clin Anesth 2003;15:351-356.
  • Gentili ME. Unilateral spinal anesthesia with a combination of hyperbaric bupivacaine and clonidine. Cah Anesthesiol 1993;41: 291-294.
  • Kuusniemi KS, Pihlajamaki KK, Pitkanen MT, Korkeila JE. Low dose bupivacaine: A comparison of hipobaric and near isobaric solution for arthroscopic surgery of the knee. Anaesthesia 1999;54: 540-545.
  • Valanne JV, Korhonen AM, Jokela RM, Ravaska P, Korttila KK. Selective spinal anesthesia: A comprasion of hyperbaric bupivacaine 4 mg versus 6 mg for outpatient knee arthroscopy. 2001; 93:1377-1379.
  • Mulroy MF, Larkin KL, Hodgson PS, Helman JD, Pollock JE, Liu SS. A comparison of spinal, epidural and general anesthesia for outpatient knee arthroscopy. Anesth Analg 2000; 91: 860-864.
  • Wang C, Chakrabarti M K, Whitwam J G. Effects of intrathecal bupivacaine on nociceptive efferent but not on sympathetic efferent pathways in dogs. Anesthesiology 1993; 79:766-773.
  • Casati A, Fanelli G, Cappelleri G, Leoni A, Berti M, Aldegheri G, Torridoes G. Does speed of intratechal injection affect the distribution of 0.5% hyperbaric bupivacaine? Br J Anaesth 1998;81: 355-357.
  • Kallio H, Snall EV, Suvanto SJ, et al. Spinal hyperbaric ropivacain-fentanyl for day-surgery. Reg Anesth Pain Med 2005; 30:48-54
  • Veghadia H, McLeod DH, Mitchell GW, Merrick PM, Chilvers CR. Small dose hypobaric lidocaine-fentanyl spinal anesthesia for short duration outpatient laparoscopic optimal fentanyl dose. Anesth Analg 1997; 84:65-77.
  • Bearsley D, Holman S, Gannt R, et al. Transient neurologic deficit after spinal anesthesia: Local anesthetic maldistribution with pencil-point needles? Anesth Analg 1995; 81:314-320.
There are 23 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Bilgehan Sönmez This is me

Murat Akçay This is me

Erkan Yavuz Akçaboy This is me

Zeynep Nur Akçaboy This is me

Ahmet Küçük This is me

Publication Date March 1, 2011
Published in Issue Year 2011 Volume: 2 Issue: 1

Cite

APA Sönmez, B., Akçay, M., Akçaboy, E. Y., Akçaboy, Z. N., et al. (2011). Tek taraflı spinal anestezide düşük doz bupivakain ve bupivakain-fentanil kombinasyonunun derlenmeye etkisi. Journal of Clinical and Experimental Investigations, 2(1), 22-29. https://doi.org/10.5799/ahinjs.01.2011.01.0205
AMA Sönmez B, Akçay M, Akçaboy EY, Akçaboy ZN, Küçük A. Tek taraflı spinal anestezide düşük doz bupivakain ve bupivakain-fentanil kombinasyonunun derlenmeye etkisi. J Clin Exp Invest. March 2011;2(1):22-29. doi:10.5799/ahinjs.01.2011.01.0205
Chicago Sönmez, Bilgehan, Murat Akçay, Erkan Yavuz Akçaboy, Zeynep Nur Akçaboy, and Ahmet Küçük. “Tek Taraflı Spinal Anestezide düşük Doz Bupivakain Ve Bupivakain-Fentanil Kombinasyonunun Derlenmeye Etkisi”. Journal of Clinical and Experimental Investigations 2, no. 1 (March 2011): 22-29. https://doi.org/10.5799/ahinjs.01.2011.01.0205.
EndNote Sönmez B, Akçay M, Akçaboy EY, Akçaboy ZN, Küçük A (March 1, 2011) Tek taraflı spinal anestezide düşük doz bupivakain ve bupivakain-fentanil kombinasyonunun derlenmeye etkisi. Journal of Clinical and Experimental Investigations 2 1 22–29.
IEEE B. Sönmez, M. Akçay, E. Y. Akçaboy, Z. N. Akçaboy, and A. Küçük, “Tek taraflı spinal anestezide düşük doz bupivakain ve bupivakain-fentanil kombinasyonunun derlenmeye etkisi”, J Clin Exp Invest, vol. 2, no. 1, pp. 22–29, 2011, doi: 10.5799/ahinjs.01.2011.01.0205.
ISNAD Sönmez, Bilgehan et al. “Tek Taraflı Spinal Anestezide düşük Doz Bupivakain Ve Bupivakain-Fentanil Kombinasyonunun Derlenmeye Etkisi”. Journal of Clinical and Experimental Investigations 2/1 (March 2011), 22-29. https://doi.org/10.5799/ahinjs.01.2011.01.0205.
JAMA Sönmez B, Akçay M, Akçaboy EY, Akçaboy ZN, Küçük A. Tek taraflı spinal anestezide düşük doz bupivakain ve bupivakain-fentanil kombinasyonunun derlenmeye etkisi. J Clin Exp Invest. 2011;2:22–29.
MLA Sönmez, Bilgehan et al. “Tek Taraflı Spinal Anestezide düşük Doz Bupivakain Ve Bupivakain-Fentanil Kombinasyonunun Derlenmeye Etkisi”. Journal of Clinical and Experimental Investigations, vol. 2, no. 1, 2011, pp. 22-29, doi:10.5799/ahinjs.01.2011.01.0205.
Vancouver Sönmez B, Akçay M, Akçaboy EY, Akçaboy ZN, Küçük A. Tek taraflı spinal anestezide düşük doz bupivakain ve bupivakain-fentanil kombinasyonunun derlenmeye etkisi. J Clin Exp Invest. 2011;2(1):22-9.