scholarly journals Sensory Block Level Prediction of Spinal Anaesthesia With 0.5% Hyperbaric Bupivacaine: A Retrospective Study

2020 ◽  
Author(s):  
Yu-Yin Huang ◽  
Kuang-Yi Chang
Keyword(s):  
Retrospective Study ◽  
Predictive Model ◽  
Spinal Anaesthesia ◽  
Linear Regression Analysis ◽  
Sensory Block ◽  
Multiple Linear Regression Analysis ◽  
Single Shot ◽  
Hyperbaric Bupivacaine ◽  
Block Height ◽  
Block Level

Abstract There is still no consensus on how to determine the dose of spinal anaesthesia with adequate sensory block for a planned surgery. This retrospective study aimed to explore the associations of miscellaneous factors with peak sensory block level after spinal anaesthesia with hyperbaric bupivacaine, and to construct a predictive model for single-shot spinal anaesthesia. We collected the records of 401 non-pregnant adults who underwent spinal anaesthesia with 0.5% hyperbaric bupivacaine at the L3-4 or L4-5 intervertebral space for lower body surgeries. Multiple linear regression analysis was used to investigate predictors of the block level and build up the predictive model. Five variables were identified as independent predictors of the peak sensory block level, including bupivacaine dose, height, weight, gender and age. The predictive model for peak block level after spinal anaesthesia could be expressed as a formula with these five variables and the estimated predictive power was 0.72. Based on this model, it is possible to determine a reasonable dose of hyperbaric bupivacaine for spinal anaesthesia, which gives adequate sensory block required for diverse surgical procedures in various patients and could be considered as a dose reference for sensory block height in spinal anaesthesia.

scholarly journals Sensory block level prediction of spinal anaesthesia with 0.5% hyperbaric bupivacaine: a retrospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu-Yin Huang ◽  
Kuang-Yi Chang
Keyword(s):  
Retrospective Study ◽  
Predictive Model ◽  
Spinal Anaesthesia ◽  
Linear Regression Analysis ◽  
Sensory Block ◽  
Multiple Linear Regression Analysis ◽  
Single Shot ◽  
Hyperbaric Bupivacaine ◽  
Block Height ◽  
Block Level

AbstractThere is still no consensus on how to determine the dose of spinal anaesthesia with adequate sensory block for a planned surgery. This retrospective study aimed to explore the associations of miscellaneous factors with peak sensory block level after spinal anaesthesia with hyperbaric bupivacaine, and to construct a predictive model for single-shot spinal anaesthesia. We collected the records of 401 non-pregnant adults who underwent spinal anaesthesia with 0.5% hyperbaric bupivacaine at the L3–4 or L4–5 intervertebral space for lower body surgeries. Multiple linear regression analysis was used to investigate predictors of the block level and build up the predictive model. Five variables were identified as independent predictors of the peak sensory block level, including bupivacaine dose, height, weight, gender and age. The predictive model for peak block level after spinal anaesthesia could be expressed as a formula with these five variables and the estimated predictive power was 0.72. Based on this model, it is possible to determine a reasonable dose of hyperbaric bupivacaine for spinal anaesthesia, which gives adequate sensory block required for diverse surgical procedures in various patients and could be considered as a dose reference for sensory block height in spinal anaesthesia.

scholarly journals Anatomical Dimensions of the Lumbar Dural Sac Predict the Sensory Block Level of Continuous Epidural Analgesia during Labor

2021 ◽  
Author(s):  
Chen-yang Xu ◽  
Can Liu ◽  
Xiao-ju Jin ◽  
Fan Yang ◽  
Fang Xu ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Linear Regression Analysis ◽  
Sensory Block ◽  
Multiple Linear Regression Analysis ◽  
Labor Analgesia ◽  
Dural Sac ◽  
Continuous Epidural Analgesia ◽  
Block Level

Abstract Background: The anatomical dimensions of the lumbar dural sac determine the sensory block level of spinal anesthesia; however, whether they show the same predictive value during continuous epidural anesthesia (CEA) remains undetermined. We designed the present study to verify the efficacy of the anatomical dimensions of the lumbar dural sac in predicting the sensory block level during labor analgesia. Methods: A total of 122 parturients with singleton pregnancies requesting labor analgesia were included in this study. The lumbar dural sac diameter (DSD), lumbar dural sac length (DSL), lumbar dural sac surface area (DSA) , and lumbar dural sac volume (DSV) were measured with an ultrasound color Doppler diagnostic apparatus. CEA was performed at the L2-L3 interspace. After epidural cannulation, an electronic infusion pump containing 0.08% ropivacaine and sufentanil 0.4 µg/ml was connected. The sensory block level was determined with alcohol-soaked cotton, a cotton swab, and a pinprick. The analgesic efficacy of CEA was determined with a visual analog scale (VAS). Divided the parturients into two groups: "ideal analgesia" and "non-ideal analgesia", and compared the groups by t test. Pearson's correlation was performed to evaluate the association between the anatomical dimensions of the lumbar dural sac and sensory block level. Multiple linear regression analysis was used to create a model for predicting the sensory block level. Results: In the "ideal analgesia" group, the height, DSL, DSA, DSV and DSD were significantly smaller, and the BMI was significantly larger (P<0.05) (Table 1). In addition, the DSL demonstrated the strongest correlation with the peak level of pain block (r=-0.816, P<0.0001; Figure 2A), temperature block (r=-0.874, P<0.0001; Figure 3A) and tactile block (r=-0.727, P<0.0001; Figure 4A). Finally, multiple linear regression analysis revealed that the DSL and BMI contributed to predicting the peak sensory block level. Conclusion: In conclusion, our study shows that the sensory block level of CEA is higher when the DSL, DSA, DSV and DSD of puerpera are lower. The DSL and BMI can be treated as predictors of the peak sensory block level in CEA during labor analgesia.

scholarly journals Anatomical dimensions of the lumbar dural sac predict the sensory block level of continuous epidural analgesia during labor

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chen-yang Xu ◽  
Can Liu ◽  
Xiao-ju Jin ◽  
Fan Yang ◽  
Fang Xu ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Linear Regression Analysis ◽  
Sensory Block ◽  
Multiple Linear Regression Analysis ◽  
Labor Analgesia ◽  
Dural Sac ◽  
Continuous Epidural Analgesia ◽  
Block Level

Abstract Background The anatomical dimensions of the lumbar dural sac determine the sensory block level of spinal anesthesia; however, whether they show the same predictive value during continuous epidural anesthesia (CEA) remains undetermined. We designed the present study to verify the efficacy of the anatomical dimensions of the lumbar dural sac in predicting the sensory block level during labor analgesia. Methods A total of 122 parturients with singleton pregnancies requesting labor analgesia were included in this study. The lumbar dural sac diameter (DSD), lumbar dural sac length (DSL), lumbar dural sac surface area (DSA), and lumbar dural sac volume (DSV) were measured with an ultrasound color Doppler diagnostic apparatus. CEA was performed at the L2-L3 interspace. After epidural cannulation, an electronic infusion pump containing 0.08% ropivacaine and sufentanil 0.4 μg/ml was connected. The sensory block level was determined with alcohol-soaked cotton, a cotton swab, and a pinprick. The analgesic efficacy of CEA was determined with a visual analog scale (VAS). The parturients were divided into two groups, “ideal analgesia” and “nonideal analgesia,” and the groups were compared by t test. Pearson’s correlation was performed to evaluate the association between the anatomical dimensions of the lumbar dural sac and sensory block level. Multiple linear regression analysis was used to create a model for predicting the sensory block level. Results In the ideal analgesia group, the height, DSL, DSA, DSV and DSD were significantly smaller, and the body mass index (BMI) was significantly larger (P < 0.05). In addition, the DSL demonstrated the strongest correlation with the peak level of pain block (r = − 0.816, P < 0.0001; Fig. 2A), temperature block (r = − 0.874, P < 0.0001; Fig. 3A) and tactile block (r = − 0.727, P < 0.0001; Fig. 4A). Finally, the multiple linear regression analysis revealed that DSL and BMI contributed to predicting the peak sensory block level. Conclusion In conclusion, our study shows that the sensory block level of CEA is higher when the DSL, DSA, DSV and DSD of puerperae are lower. DSL and BMI can be treated as predictors of the peak sensory block level in CEA during labor analgesia.

The effect of intra-abdominal pressure on sensory block level of single-shot spinal anesthesia for cesarean section: an observational study

2015 ◽  
Vol 24 (1) ◽  
pp. 35-40 ◽  
Author(s):  
T. Ozkan Seyhan ◽  
M. Orhan-Sungur ◽  
B. Basaran ◽  
M. Savran Karadeniz ◽  
F. Demircan ◽  
...  
Keyword(s):  
Observational Study ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Sensory Block ◽  
Abdominal Pressure ◽  
Single Shot ◽  
Block Level

The relation between skin temperature increase and sensory block height in spinal anaesthesia using infrared thermography

2010 ◽  
Vol 54 (9) ◽  
pp. 1105-1110 ◽  
Author(s):  
F. G. A. M. Van HAREN ◽  
J. J. DRIESSEN ◽  
L. KADIC ◽  
J. Van EGMOND ◽  
L. H. D. J. BOOIJ ◽  
...  
Keyword(s):  
Skin Temperature ◽  
Infrared Thermography ◽  
Spinal Anaesthesia ◽  
Temperature Increase ◽  
Sensory Block ◽  
Block Height

scholarly journals Comparative Effects of Single Shot Intrathecal Bupivacaine with Dexmedetomidine and Bupivacaine with Fentanyl on Labor Outcome

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
S. Fyneface-Ogan ◽  
O. Gogo Job ◽  
C. E. Enyindah
Keyword(s):  
Motor Block ◽  
Neonatal Outcome ◽  
Stress Hormones ◽  
Sensory Block ◽  
Pain Scale ◽  
Labor Pain ◽  
Single Shot ◽  
Hyperbaric Bupivacaine ◽  
Multiparous Women ◽  
Beta Endorphins

Background. Effective intrapartum analgesia attenuates pain, stress, and anxiety which cause release of stress hormones as well as beta-endorphins. Aim. The purpose of this study was to determine the effect of adding dexmedetomidine to hyperbaric bupivacaine for neuraxial analgesia for labor. Methods. Ninety laboring multiparous women were allocated to have single shot intrathecal bupivacaine alone (B), bupivacaine with fentanyl (BF), or bupivacaine with dexmedetomidine (BD). Sensory and motor block characteristics; time from injection to two dermatome sensory regression, sensory regression to S1 dermatome, and motor block regression to Bromage 1 were recorded. Labor pain was assessed with a 10 cm verbal pain scale. Results. Peak sensory block levels in the three groups were essentially the same (). The time for sensory and motor blocks to reach T10 dermatome and Bromage 1, respectively, was faster in group BD than in the other groups (). The time for sensory regression to S1 was significantly prolonged in the group BD (). Motor block regression time to Bromage 1 was also prolonged in the group BD (). Neonatal outcome was normal in all groups. Conclusion. Single shot intrathecal bupivacaine/dexmedetomidine significantly prolonged sensory block in laboring women.

scholarly journals Comparison of Intrathecal Fentanyl and Butorphanol as an Adjuvant to Intrathecal Bupivacaine 0.5% in Infraumbilical Surgeries- A Randomised Double Blind Study

2020 ◽  
Author(s):  
Sandip Roy Basunia ◽  
Prosenjit Mukherjee ◽  
Md Bakir Hossain Munshi
Keyword(s):  
Spinal Anaesthesia ◽  
Motor Block ◽  
Controlled Trial ◽  
Sensory Block ◽  
P Value ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Group A ◽  
Group B

Introduction: Neuraxial opioids are widely used as adjuvants to local anaesthetic as they improve quality and duration of block. Neuraxial opioids like Butorphanol and Fentanyl allow prolonged analgesia in the postoperative period and faster recovery from spinal anaesthesia. Aim: To compare the safety and efficacy of Butorphanol and Fentanyl combined with bupivacaine for spinal anaesthesia in infraumbilical surgeries. Materials and Methods: The present study was a randomised controlled trial in which 110, ASA I and II patients of either sex who underwent elective infraumbilical surgeries under spinal anaesthesia were selected. Patients were allocated randomly into two groups A (n=55) and B (n=55). Group A (F) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with fentanyl 25 microgram (0.5 mL) to make it total 3.5 mL. Group B (B) received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg (3 mL) with butorphanol 250 microgram (0.25 mL) and Normal Saline (NS) 0.25 mL to make it total 3.5 mL. Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP), two segment regression time of sensory block, motor block were assessed at preset intervals. Chi-square test or Fischer’s-exact test were used and a p-value ≤0.05 was considered as statistically significant. Results: Mean of two segment sensory regression time of Group A was 41.94±1.73 minutes and Group B was 50.56±4.43 minutes (p<0.0001). Time to onset of motor block in Group A was 5.28±.32 minutes and Group B was 5.27±.32 minutes (p=0.96). Mean duration of motor block in Group A was 81.23±4.87 minutes and Group B was 109.83±2.61 minutes (p<0.0001). Time to rescue analgesic was 289.27±7.37 minutes in Group A and 378.41±10.25 minutes in Group B (p<0.0001). HR, SBP and DBP were comparable among the groups. Conclusion: Intrathecal bupivacaine-butorphanol mixture was clinically better as it provided longer duration of analgesia with lesser incidences of pruritus and nausea/vomiting compared to intrathecal fentanyl-bupivacaine mixture.

Subanalgesic doses of ketamine and morphine but not morphine alone, prolong the sensory block time of hyperbaric bupivacaine in unilateral spinal anaesthesia

2004 ◽  
Vol 16 (4) ◽  
pp. 435-439
Author(s):  
Emin Alp Yentür ◽  
Demet Tok ◽  
Gönül Tezcan Keleş ◽  
Verda Toprak ◽  
Füsun Aslan
Keyword(s):  
Spinal Anaesthesia ◽  
Sensory Block ◽  
Hyperbaric Bupivacaine ◽  
Block Time

Comparative study between the effect of intrathecal bupivacaine versus bupivacaine dexmedetomidine combination in spinal anaeshtesia for lower abdominal surgeries

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mervat M Marzouk ◽  
Wael R Thabet ◽  
Tarek M Ashoor ◽  
Ahmed Morsy Ahmed
Keyword(s):  
Blood Pressure ◽  
Spinal Anaesthesia ◽  
Primary Outcome ◽  
Sensory Block ◽  
University Hospital ◽  
Rescue Analgesia ◽  
Blinded Study ◽  
Hospital Patients ◽  
Block Level ◽  
Double Blinded

Abstract Study objectives We compared effect of intrathecal bupivacaine versus bupivacaine Design This is a prospective, randomized, double-blinded study. Setting The setting is at an operating room in Ain Shams University Hospital. Patients: 50 patients scheduled for general anesthesia were randomly allocated to the following 2 groups in equal numbers. Interventions Spinal anaesthesia will be performed in the sitting position at L3-L4 or L4-L5 level using a 25-gauge Quincke spinal needle by the most competent experts. The sensory block level will be assessed along the mid-clavicular line bilaterally. The motor block will be assessed according to Bromage scale Measurements Post operative (VAS) score and Time to first requested analgesia.(primary outcome), Systolic blood pressure, diastolic blood pressure, mean blood pressure and heart rate will be recorded every 5 minutes for 20 minutes then every 15 minutes till the end of surgery, Nausea and/ or vomiting as yes/no, Level of highest sensory block, Bromage score ≥3, Onset of sensory block and Two segment regression time (secondary outcomes) were recorded.. Main results Results of this study showed that the addition of dexmedetomidine to bupivacaine in spinal anaesthesia significantly prolonged both sensory and motor blockades duration compared with bupivacaine alone. They also prolonged the time of postoperative analgesia as evidenced by significantly longer time to first rescue analgesia and lower NRS scores with minimal adverse effects and haemodynamic stability. Conclusions We concluded that intrathecal dexmedetomidine increases the duration of analgesia and reduces postoperative pain without changes in the hemodynamic parameters and adverse side effects. It can be considered as an appropriate adjuvant to intrathecal local anesthetics for lower abdominal surgeries.

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