The Influence Of Temperature On Spread Of Intrathecal Levobupıvacaıne

G. Aydın, Asiye Süslü, O. Özlü, M. Aksoy, R. Polat
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Abstract

Background: The distrubition of spinal anesthesia is affected by many factors such as the density and viscosity and temperature of the local anesthetics. We aimed to compare the effects of 37 oC plain %0.5 levobupivacaine versus 24oC levobupivacaine in regards of intraoperative anesthetic and postoperative analgesic conditions for patients undergoing arthroscopic menisectomy. Methods: In this randomized, blind, prospective trial a total of fifty three patients aged 17-70 years (ASA I-II) scheduled to have elective ambulatory arthroscopic menisectomy of the knee were randomly allocated into two groups. All patients received intrathecal 3 mL of plain % 0.5 levobupivacaine. Group 1 received the solution that had been previously equilibrated to 37 oC and group 2 received at room temperature(24oC) . Sensory blockade was assessed by loss of pinprick sensation and motor block was assessed using a modified Bromage scale. Readiness of surgery was defined as presence of adequate motor blockade (Bromage ≥ 2) and loss of pinprick sensation at L1 at the operative side. Visual analog scale was used to define patients degree of pain.Results: The mean time required to achive readiness to surgery was 5.07±0.39 minutes in Group 1 and 10.37±1.13 minutes in Group 2 (p 0.05).Conclusions: We showed an increase in initial cephaled migration of block for the first 10 minutes by warming levobupivacaine % 0.5 from room temperature(24oC) to 37oC.
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温度对鞘内扩散的影响Levobupıvacaıne
背景:脊髓麻醉的分布受局麻药的密度、粘度和温度等多种因素的影响。我们的目的是比较37℃普通%0.5左布比卡因与24℃左布比卡因对关节镜半月板切除术患者术中麻醉和术后镇痛的影响。方法:在这项随机、盲、前瞻性试验中,共有53名17-70岁(ASA I-II)的患者计划进行选择性关节镜下膝关节半月板切除术,随机分为两组。所有患者鞘内均给予3ml普通% 0.5左布比卡因。第一组接受之前平衡到37℃的溶液,第二组接受室温(24℃)的溶液。通过针刺感觉的丧失来评估感觉阻滞,使用改良的Bromage量表来评估运动阻滞。手术准备的定义是存在足够的运动阻断(Bromage≥2)和手术侧L1处针刺感觉的丧失。采用视觉模拟量表评定患者疼痛程度。结果:1组平均手术准备时间为5.07±0.39 min, 2组平均手术准备时间为10.37±1.13 min (p < 0.05)。结论:我们发现左旋布比卡因% 0.5从室温(24℃)加热到37℃,头10分钟内阻滞的初始头部迁移增加。
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