Características clínicas de levobupivacaína espinal hiperbárica comparada con isobárica
Clinical characteristics of spinal levobupivacaine: hyperbaric compared with isobaric solution.
Sanansilp V, Trivate T, Chompubai P, Visalyaputra S, Suksopee P, Permpolprasert L, von Bormann B.
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
ScientificWorldJournal. 2012;2012:169076. doi: 10.1100/2012/169076. Epub 2012 Apr 24.
Abstract
We performed a prospective, double-blinded study in 20 patients undergoing gynecologic surgery with lower abdominal incision, to investigate characteristics of intrathecal hyperbaric levobupivacaine compared with isobaric levobupivacaine. We randomly assigned them to receive either isobaric or hyperbaric 0.42% levobupivacaine intrathecally. We found that hyperbaric levobupivacaine, compared with isobaric levobupivacaine, spread faster to T10 level (2.8 ± 1.1 versus 6.6 ± 4.7 minutes, P = 0.039), reached higher sensory block levels at 5 and 15 minutes after injection (T8 versus L1, P = 0.011, and T4 versus T7, P = 0.027, resp.), and had a higher peak level (T4 versus T8, P = 0.040). Isobaric levobupivacaine caused a wider range of peak levels (L1 to C8) compared with hyperbaric form (T7 to T2). The level of T4 or higher reached 90% in the hyperbaric group compared with 20% in the isobaric group (P = 0.005). Our results suggest that hyperbaric levobupivacaine was more predictable for sensory block level and more effective for surgical procedures with lower abdominal approach. Hyperbaric levobupivacaine seems to be suitable, but the optimal dosage needs further investigation.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349113/pdf/TSWJ2012-169076.pdf
Comparación entre levobupivacaína sola y en combinación con fentanilo y sufentanilo en pacientes para prostatectomía
Comparison of levobupivacaine alone and in combination with fentanyl and sufentanil in patients undergoing transurethral resection of the prostate.
Akan B, Yagan O, Bilal B, Erdem D, Gogus N.
Department of Anesthesia and Reanimation, Numune Training and Research Hospital, Ankara, Turkey.
J Res Med Sci. 2013 May;18(5):378-82.
Abstract
BACKGROUND:It was aimed to compare the efficacy and adverse effects of levobupivacaine alone and in combination with fentanyl and sufentanil during transurethral resection of the prostate (TURP) under spinal anesthesia.MATERIALS AND METHODS:In this prospective, randomized, double-blind trial, 60 patients undergoing elective TURP under spinal anesthesia were randomized into three groups. Ten milligrams of 0.5% levobupivacaine in Group-I, 7.5 mg 0.5% levobupivacaine combined with 25 μg fentanyl in Group-II and 7.5 mg 0.5% levobupivacaine with 2.5 μg sufentanil in Group-III were administered intrathecally. RESULTS: The time for sensorial block to reach level T10 was 10.2 ± 2.0, 6.9 ± 1.7 and 7.0 ± 1.4 min in Group-I, II and III, respectively (P < 0.001). The maximum sensorial block level was T8 in all groups. The frequency of a complete motor block was higher in Group-I. The mean duration of motor block was shorter in Group-II and III than in Group-I (P < 0.001). There were no differences between groups regarding side effects (P > 0.05). The time for first analgesic request was shorter in Group-I than in the other two groups (P < 0.05). During the first postoperative 24-h period, 11 (58%) patients in Group-I, 9 (48%) patients in Group II and 9 (45%) patients in Group-III required an analgesic drug (P > 0.05). CONCLUSION: This study showed that combining lower dose levobupivacaine with fentanyl and sufentanil provides faster onset of sensorial block, lower frequency and shorter duration of motor block, and longer analgesia time in TURP under spinal anesthesia.
KEYWORDS: Fentanyl, levobupivacaine, spinal anesthesia, sufentanil, transurethral resection of the prostate
http://journals.mui.ac.ir/jrms/article/view/9206/3898
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810569/
Influencia de la posición sobre levobupivacaína isobárica en anestesia espinal para cesárea
Influence of positioning on plain levobupivacaine spinal anesthesia in cesarean section.
Gori F, Corradetti F, Cerotto V, Peduto VA.
Section of Anesthesia and Intensive Care, University of Perugia, 06100 Perugia, Italy.
Anesthesiol Res Pract. 2010;2010. pii: 212696. doi: 10.1155/2010/212696. Epub 2010 May 24.
Abstract
Background. The behaviour of isobaric levobupivacaine in relation to gravity when used in obstetric spinal anesthesia is unclear. Methods. 46 women with ASA physical status 1 undergoing cesarean section were randomly allocated to 2 groups. Spinal anesthesia with 12.5 mg levobupivacaine was performed in the sitting position in all women. Those in the first group were placed in the supine position immediately after the injection, while those in the second group were asked to remain seated for 2 minutes before assuming the supine position. The sensory block level, the onset of sensory and motor blocks, the regression of the sensory block for 2 dermatomes of the sensory block, the first request for analgesics, and the regression of motor block were recorded. Results. No differences in onset times, sensory level, or Bromage score were observed between the two groups. The time of first analgesic request was earlier in the seated group (supine 131 +/- 42 min, seated 106 +/- 29 min, P = .02). Conclusion. Isobaric levobupivacaine in women at term produces a subarachnoid block the dermatomal level of which does not depend on gravitational forces.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911613/pdf/ARP2010-212696.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Clinical characteristics of spinal levobupivacaine: hyperbaric compared with isobaric solution.
Sanansilp V, Trivate T, Chompubai P, Visalyaputra S, Suksopee P, Permpolprasert L, von Bormann B.
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
ScientificWorldJournal. 2012;2012:169076. doi: 10.1100/2012/169076. Epub 2012 Apr 24.
Abstract
We performed a prospective, double-blinded study in 20 patients undergoing gynecologic surgery with lower abdominal incision, to investigate characteristics of intrathecal hyperbaric levobupivacaine compared with isobaric levobupivacaine. We randomly assigned them to receive either isobaric or hyperbaric 0.42% levobupivacaine intrathecally. We found that hyperbaric levobupivacaine, compared with isobaric levobupivacaine, spread faster to T10 level (2.8 ± 1.1 versus 6.6 ± 4.7 minutes, P = 0.039), reached higher sensory block levels at 5 and 15 minutes after injection (T8 versus L1, P = 0.011, and T4 versus T7, P = 0.027, resp.), and had a higher peak level (T4 versus T8, P = 0.040). Isobaric levobupivacaine caused a wider range of peak levels (L1 to C8) compared with hyperbaric form (T7 to T2). The level of T4 or higher reached 90% in the hyperbaric group compared with 20% in the isobaric group (P = 0.005). Our results suggest that hyperbaric levobupivacaine was more predictable for sensory block level and more effective for surgical procedures with lower abdominal approach. Hyperbaric levobupivacaine seems to be suitable, but the optimal dosage needs further investigation.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349113/pdf/TSWJ2012-169076.pdf
Comparación entre levobupivacaína sola y en combinación con fentanilo y sufentanilo en pacientes para prostatectomía
Comparison of levobupivacaine alone and in combination with fentanyl and sufentanil in patients undergoing transurethral resection of the prostate.
Akan B, Yagan O, Bilal B, Erdem D, Gogus N.
Department of Anesthesia and Reanimation, Numune Training and Research Hospital, Ankara, Turkey.
J Res Med Sci. 2013 May;18(5):378-82.
Abstract
BACKGROUND:It was aimed to compare the efficacy and adverse effects of levobupivacaine alone and in combination with fentanyl and sufentanil during transurethral resection of the prostate (TURP) under spinal anesthesia.MATERIALS AND METHODS:In this prospective, randomized, double-blind trial, 60 patients undergoing elective TURP under spinal anesthesia were randomized into three groups. Ten milligrams of 0.5% levobupivacaine in Group-I, 7.5 mg 0.5% levobupivacaine combined with 25 μg fentanyl in Group-II and 7.5 mg 0.5% levobupivacaine with 2.5 μg sufentanil in Group-III were administered intrathecally. RESULTS: The time for sensorial block to reach level T10 was 10.2 ± 2.0, 6.9 ± 1.7 and 7.0 ± 1.4 min in Group-I, II and III, respectively (P < 0.001). The maximum sensorial block level was T8 in all groups. The frequency of a complete motor block was higher in Group-I. The mean duration of motor block was shorter in Group-II and III than in Group-I (P < 0.001). There were no differences between groups regarding side effects (P > 0.05). The time for first analgesic request was shorter in Group-I than in the other two groups (P < 0.05). During the first postoperative 24-h period, 11 (58%) patients in Group-I, 9 (48%) patients in Group II and 9 (45%) patients in Group-III required an analgesic drug (P > 0.05). CONCLUSION: This study showed that combining lower dose levobupivacaine with fentanyl and sufentanil provides faster onset of sensorial block, lower frequency and shorter duration of motor block, and longer analgesia time in TURP under spinal anesthesia.
KEYWORDS: Fentanyl, levobupivacaine, spinal anesthesia, sufentanil, transurethral resection of the prostate
http://journals.mui.ac.ir/jrms/article/view/9206/3898
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810569/
Influencia de la posición sobre levobupivacaína isobárica en anestesia espinal para cesárea
Influence of positioning on plain levobupivacaine spinal anesthesia in cesarean section.
Gori F, Corradetti F, Cerotto V, Peduto VA.
Section of Anesthesia and Intensive Care, University of Perugia, 06100 Perugia, Italy.
Anesthesiol Res Pract. 2010;2010. pii: 212696. doi: 10.1155/2010/212696. Epub 2010 May 24.
Abstract
Background. The behaviour of isobaric levobupivacaine in relation to gravity when used in obstetric spinal anesthesia is unclear. Methods. 46 women with ASA physical status 1 undergoing cesarean section were randomly allocated to 2 groups. Spinal anesthesia with 12.5 mg levobupivacaine was performed in the sitting position in all women. Those in the first group were placed in the supine position immediately after the injection, while those in the second group were asked to remain seated for 2 minutes before assuming the supine position. The sensory block level, the onset of sensory and motor blocks, the regression of the sensory block for 2 dermatomes of the sensory block, the first request for analgesics, and the regression of motor block were recorded. Results. No differences in onset times, sensory level, or Bromage score were observed between the two groups. The time of first analgesic request was earlier in the seated group (supine 131 +/- 42 min, seated 106 +/- 29 min, P = .02). Conclusion. Isobaric levobupivacaine in women at term produces a subarachnoid block the dermatomal level of which does not depend on gravitational forces.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2911613/pdf/ARP2010-212696.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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