TABLE 3 - uploaded by Ivana Tudoric Djeno
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Source publication
The clinical presentation of a subarachnoid block (SAB) is dependent upon the intrathecal spread of local anesthetic (LA). Intrathecal distribution depends on the chemical and physical characteristics of LA, puncture site, technique used, patient anatomical characteristics and hydrodynamic properties of cerebrospinal fluid. We tried to determine wh...
Context in source publication
Context 1
... intensity assessed during the first postoperative hour was significantly higher in the Hyper group when compared to the Hypo group, p<0.03, while at 6 and 12 hours postoperatively, there was no pain present. Table 2 Side effects during the first 24 hours do not differ be- tween groups (Table 3). ...
Citations
... Há relatos na literatura de que um aumento da densidade da solução anestesia local tem o efeito de acelerar a latência 6,9,26,27 e aumentar o nível máximo de bloqueio. 4,27 No presente estudo, o tempo até a recuperação total dos bloqueios sensorial e motor foi menor no Grupo I. Há vários estudos sobre o efeito do aumento da densidade da solução de anestésico local sobre a duração dos bloqueios sensorial e motor. Em um estudo conduzido por Janik et al. 28 que comparou soluções de bupivacaína com glicose a 8% e 5%, relatou-se que a concentração maior de glicose prolongou significativamente a duração do bloqueio sensorial. ...
Resumo
Justificativa e objetivos
Comparar as características do bloqueio e os efeitos clínicos da adição de dextrose às soluções de levobupivacaína em diferentes concentrações para proporcionar raquianestesia unilateral em cirurgia de extremidade inferior.
Métodos
Estudo prospectivo, randômico e duplo‐cego conduzido com 75 pacientes, estado físico ASA I‐II, programados para artroplastia unilateral total do joelho. Os pacientes foram divididos em três grupos: no Grupo‐I, 60 mg de dextrose foram adicionados a 7,5 mg de levobupivacaína a 0,5%; no Grupo II, 80 mg e no Grupo III, 100 mg. A raquianestesia foi aplicada ao paciente posicionado em decúbito lateral, com o lado operado abaixo, e o paciente foi mantido em posição durante 10 minutos.
Resultados
O tempo para o bloqueio sensorial atingir o nível T12 foi mais lento no Grupo‐I do que nos grupos II e III (p < 0,05, p < 0,00). O tempo de recuperação total do bloqueio sensorial foi de 136 minutos no Grupo‐I, 154 minutos no Grupo‐II e 170 minutos no Grupo III. As diferenças foram estatisticamente significativas (p < 0,05). A média da duração do bloqueio motor foi de 88 minutos no Grupo‐I, 105 minutos no Grupo‐II e 139 minutos no Grupo‐III e as diferenças foram estatisticamente significativas (p < 0,05). O tempo de micção foi significativamente menor no Grupo‐I do que nos outros grupos (p < 0,00).
Conclusões
Os resultados do estudo mostraram que, junto com um aumento da densidade, a duração dos bloqueios sensorial e motor foi prolongada. Pode‐se concluir que uma concentração 30 mg mL⁻¹ de dextrose adicionada a 7,5 mg de levobupivacaína é suficiente para proporcionar raquianestesia unilateral para artroscopia do joelho em regime ambulatorial.
... In literature it has been reported that an increase in local anaesthesia solution density has the effect of accelerating onset 6,9,26,27 and causes an increase in maximum block level. 4,27 In the current study, the time to full recovery of both sensory and motor blocks was shorter in Group I. There have been various studies on the effect of an increase in local anaesthetic solution density on the duration of sensory and motor block. ...
The aim of the study was to compare the block characteristics and clinical effects of dextrose added to levobupivacaine solutions at different concentrations to provide unilateral spinal anaesthesia in lower extremity surgery.Methods
This prospective, randomised, double-blind study comprised 75 ASA I–II risk patients for whom unilateral total knee arthroscopy was planned. The patients were assigned to three groups: in Group I, 60 mg dextrose was added to 7.5 mg of 0.5% levobupivacaine, in Group II, 80 mg and in Group III, 100 mg. Spinal anaesthesia was applied to the patient in the lateral decubitus position with the operated side below and the patient was kept in position for 10 min.ResultsThe time for the sensorial block to achieve T12 level was slower in Group I than in Groups II and III (p < 0.05, p < 0.00). The time to full recovery of the sensorial block was 136 min in Group I, 154 min in Group II and 170 min in Group III. The differences were statistically significant (p < 0.05). The mean duration of the motor block was 88 min in Group I, 105 min in Group II, and 139 min in Group III and the differences were statistically significant (p < 0.05). The time to urination in Group I was statistically significantly shorter than in the other groups (p < 0.00).Conclusions
The results of the study showed that together with an increase in density, the sensory and motor block duration was lengthened. It can be concluded that 30 mg mL−1 concentration of dextrose added to 7.5 mg levobupivacaine is sufficient to provide unilateral spinal anaesthesia in day-case arthroscopic knee surgery.
In this prospective observational study we analysed anesthetic techniques used in high risk surgical patients who underwent hybrid peripheral revascularization. According to the anticipated duration of surgery, anesthesiologists chose general anesthesia (GA), single-shot or intermittent subarachnoid block (ISAB). The aim of this paper was to present the intraoperative conditions during single-shot subarachnoid block (SS SAB) compared to ISAB with spinal catheter placement. Spinal block distributionwas assessed at the beginning and at the end of the surgery. This study has shown that ISAB is a viable alternative in prolonged hybrid vascular procedures, especially when general anesthesia carries great risk for the patient.
