Evaluation of Efficacy of Different Identification Tests to Distinguish Cerebrospinal Fluid from Local Anaesthetic Solution: A Comparative Study

Abstract

Background: Local anaesthetics (LAs) are used clinically for anaesthesia and analgesia either following surgery or for management of other acute and chronic pain conditions; they only last a few hours. Various methods have been mentioned in the past literature for differentiating the CSF and the local anaesthetic solutions. Hence; we planned the present study to check and compare the efficacy of simple identifications tests to distinguish local anesthetic solutions from CSF. Materials & Methods: We planned the present study to compare the efficacy of simple identifications tests to distinguish local anesthetic solutions from CSF. We involved five experienced anesthetists for the present study. Both the anesthetics were asked to identify 0.1 ml sample of bupivacaine and mock CSF (tap water) by each of four physicochemical characteristics based on criteria: Temperature, pH, Presence of glucose, and Turbidity when mixed with thiopentone. The anesthetics involved in the present study were unaware of the results. All the results were recorded on excel sheet and were analyzed by SPSS software. Results: The two test solutions were identified conveniently together with the four physiochemical tests. However; the anesthetics were not able to identify and differentiate the solutions clearly with individual tests. Conclusion: Anesthetist should be accustomed with different physicochemical methods available for differentiating between CSF and local anaesthetic solution. However; no single test appears to have complete reliability. Therefore, combinations of tests must be used.