Raquia/Spinal anesthesia

Prolongación no usual de la anestesia raquídea despues de levobupicacaína 0.5%


An unusually prolonged duration of spinal anaesthesia following 0.5% Levobupivacaine
Fatma Ertugrul, Zekiye Bigat, Nurten Kayacan, Bilge Karsli
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
J Pak Med Assoc Vol. 62, No. 11, November 2012
Abstract
Spinal anaesthesia is the method of choice for elective caesarean delivery. Levobupivacaine may produce a sensory and motor block that is different from that produced by bupivacaine, the most popular local anaesthetic for parturients undergoing caesarean section (CS). We present a case of unexpectedly prolonged spinal anaesthesia following a successful spinal block with levobupivacaine. There was no evidence of any neurological injury in this patient during injection.
Keywords: Anaesthesia: spinal, Anaesthetics: local.

http://www.jpma.org.pk/PdfDownload/3811.pdf



Prolongación dosis dependiente de la raquianestesia con bupivacaína hiperbárica con dexmedetomidina

Dose-Related Prolongation of Hyperbaric Bupivacaine Spinal Anesthesia by dexmedetomidine
Hala E A Eid MD, Mohamed A Shafie MD, Hend Youssef MD.
Department of Anesthesiology, Intensive Care and Pain Management
Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ain Shams Journal of Anesthesiology Vol 4-2; July 2011
Abstract
Background and Objectives: This study aims to investigate the effect of intrathecal administration of dexmedetomidine on the duration of sensory and motor block and postoperative analgesic requirements produced by spinal bupivacaine. Methods: Forty eight adult patients scheduled for anterior cruciate ligament reconstruction were randomized to one
of three groups. Each patient was given 3.5 ml spinal injectate that consisted of 3 ml 0.5% hyperbaric bupivacaine and 0.5 ml containing either 10 μg dexmedetomidine (Group D1), 15 μg dexmedetomidine (D2) or normal saline (Group B). Heart rate, arterial blood pressure,
sensory level, motor block, pain and level of sedation were assessed intraoperatively and up to 24 hours after spinal anesthesia. The incidence of adverse effects was recorded. Results: Dexmedetomidine significantly prolonged time to two segment regression, sensory regression to S1, regression of motor block to modified Bromage 0 and time to first rescue analgesic. In addition, it significantly decreased postoperative pain scores. The effects were greater in group D2 than in group D1. In addition, group D2 patients had higher sedation scores and
lower postoperative analgesic requirements than Group D1 or B. Hemodynamic stability was maintained in the three groups. Conclusion: Intrathecal dexmedetomidine in doses of 10 μg and 15 μg significantly prolong the anesthetic and analgesic effects of spinal hyperbaric
bupivacaine in a dose-dependent manner. A fifteen μg dose may be of benefit for prolonged complex lower limb surgical procedures.
http://asja-eg.com/articles/149.pdf





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Anestesiología y Medicina del Dolor
www.anestesia-dolor.org