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Canadian Journal of Anesthesia, Vol 42, 691-694, Copyright © 1995 by Canadian Anesthesiologists' Society

ARTICLES

Hypobaric spinal anaesthesia with bupivacaine (0.1%) gives selective sensory block for ano-rectal surgery

M Maroof, RM Khan, M Siddique and M Tariq
Department of Anesthesiology, King Fahad National Guard Hospital, Riyadh, Saudi Arabia.

Twenty adult male patients undergoing anorectal surgery in the jackknife position under spinal anaesthesia were studied for the anaesthetic properties of 5 ml hypobaric 0.1% bupivacaine. The patients were positioned in the prone, jack-knife position with a pillow under the hips and with an operating table break angulation of 30 degrees with head down tilt of 20 degrees. In this position a 25-gauge Quincke spinal needle was inserted intrathecally through L3-4 and 5 ml solution, prepared by mixing 1 ml bupivacaine 0.5% with 4 ml of distilled water with a specific gravity of 1.001 at 20 degrees C, was given over 15-20 sec. Onset time, progression and upper level of sensory blockade evaluated by pin prick, and the extent of motor block (1 = full motor movement at ankle and knee joint, 2 = restricted motor movements, 3 = full motor block, no movements) were measured at one minute intervals for the first five minutes, then every five minutes for 30 min. The number of dermatomes blocked was also noted. The median level of cephalad sensory blockage was of L1, with a range from T10-L3. On average, nine dermatomes were blocked (range 7-12). Motor blockade was not observed in any patient. Changes in heart rate and blood pressure were minimal. The average duration of postoperative analgesia was 339.5 +/- 182.9 min. Post-spinal headache was not observed in any patients. In conclusion, 5 ml intrathecal hypobaric bupivacaine, 0.1%, provided excellent perioperative analgesia without motor blockade and haemodynamic stability in patients undergoing anorectal surgery in jackknife position.


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A. Faust, R. Fournier, E. Van Gessel, A. Weber, P. Hoffmeyer, and Z. Gamulin
Isobaric Versus Hypobaric Spinal Bupivacaine for Total Hip Arthroplasty in the Lateral Position
Anesth. Analg., August 1, 2003; 97(2): 589 - 594.
[Abstract] [Full Text] [PDF]


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Copyright © 1995 by the Canadian Anesthesiologists' Society.