Effects of Using 37°C Bupivacaine on Spinal Block Characteristics and Shivering

Aim: Changes in the temperature and density of local anaesthesia agents used in the applicaton of spinal anaesthesia have been shown to be related to the dissemination of these drugs in the cerebral spinal fluid. Shivering seen related to spinal anaesthesia is extremely discomforting for the patient and the etiology is not fully understood. The aim of this study was to compare the effects on spinal block characteristics and shivering of bupivacaine stored at 23%u02DAC or at 37%u02DAC for use in spinal anaesthesia. Material and Method: A total of 80 patients who were to undergo elective caesarean section surgery were randomly separated into 2 groups. Spinal anaesthesia was applied to the patients in Group 1 using bupivacaine stored at room temperature of 23%u02DAC and to the patients in Group 2 usng bupivacaine stored at 37%u02DAC. A record was made of the time taken to reach the maximum sensory block in the dermatome field, the sensory block level at every minute in the first 10 minutes and at 5-minute intervals thereafter, blood pressure, body temperature, and the incidence of shivering. Results: No difference was determined between the groups in respect of demographic data. A more rapid onset of sensory and motor block and more rapid cephalic dissemination was observed in Group 2. The incidence of shivering was found to be lower in Group 2 with the warmer bupivacaine (p=0.022). Discussion: Raising the temperature to 37%u02DAC in the local anaesthetic agent used in spinal anaesthesia of caesarean operations could achieve a more rapid sensory and motor block and could reduce the incidence of shivering