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Low‐dose bupivacaine: a comparison of hypobaric and near isobaric solutions for arthroscopic surgery of the knee
Author(s) -
Kuusniemi K. S.,
Pihlajamäki K. K.,
Pitkänen M. T.,
Korkeila J. E.
Publication year - 1999
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1046/j.1365-2044.1999.00855.x
Subject(s) - medicine , bupivacaine , anesthesia , supine position , motor block , spinal anesthesia , isobaric process , surgery , hemodynamics , local anesthetic , physics , thermodynamics
The results of studies on the effect of volume, concentration or total dose of local anaesthetic on the spread of spinal anaesthesia are inconclusive. Most support the assumption that the total dosage is more important than the volume. We compared low‐dose bupivacaine (6 mg) in 0.5% and 0.18% solutions as sole anaesthetic to achieve predominantly unilateral spinal anaesthesia for knee arthroscopy. Sixty patients were randomly allocated to two groups to receive either 1.2 ml 0.5% bupivacaine (6 mg) ( n = 30) or 3.4 ml 0.18% hypobaric bupivacaine (6.1 mg) ( n = 30). Drugs were administered at the L 3–4 interspace with the patient in the lateral position. Patients remained in this position for 20 min before being turned supine for the operation. Spinal block was assessed by pinprick and modified Bromage scale and compared between the operated and nonoperated sides. No significant changes were found in the spread or duration of sensory or motor block (p > 0.05). The haemodynamic changes were also similar between the groups. The same pinprick level of analgesia, degree of motor block and duration of spinal anaesthesia was obtained with bupivacaine (6 mg) in low (1.2 ml) or high (3.4 ml) volumes.