Abstract
Background . There is no universal approach to spinal anaesthesia (SA) in prone position according to type, dose and baricity of local anesthetic agent. Aim of the study is to compare isobaric and hyperbaric bupivacaine for SA for lumbar spine surgery. Methods .A total of 144 patients were divided into 3 groups (48 pts in each). In the group HB5 SA with heavy bupivacaine 0,5%-3,5 ml with exposure 5 min in supine position was performed. In the group HB10 SA with the same bupivacaine but with exposure 10 min was performed. In the group IB patients were anaesthetized with isobaric bupivacaine 0,5%-3,5 ml and than turned by themselves to prone position immediately after injection. We examined the level of sensory and motor block, and hemodynamics 15 min and 3 hrs after injection of bupivacaine. Results . The level of sensory block was higher in both hyperbaric groups compared to isobaric. Anywhere it was enough for surgery L3 and lower in all cases. Motor block was Bromage3 in all groups. After 3 hours, sensory level was the highest in the group HB5, and motor block was the highest in the group HB10. The most stable hemodynamics was in in group IB, and the most unstable in the group HB10. Conclusions . Isobaric bupivacaine is preferable for SA for lumbar spine surgery that lasts for 3 hrs and less due to stable hemodynamics and early start of surgery. For longer surgery hyperbaric bupivacaine may be recommended with exposure time in supine position for 5 min.
Published Version
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