Effect of Subarachnoid Bupivacaine Block on Anesthetic Requirements for Thiopental in Rats

Eappen, Sunil; Kissin, Igor

doi:10.1097/00000542-199804000-00024

Cited by 51 publications

(29 citation statements)

References 20 publications

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“…This idea was further supported by animal studies. [9][10][11][12][13][14] In particular, in a series of works in goats, Antognini and colleagues 9-13 elegantly showed that pharmacological blockage of the spinal cord depressed the activating action of the forebrain reticular formation on cortical EEG. Depression of brainstem activity by epidural anesthesia was also confirmed in humans.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8] The sedative effect of spinal anesthesia could be due to the loss of somatosensory inputs to the brain, as suggested by animal studies. [9][10][11][12][13][14] Therefore, at least in principle, spinal cord injury should have the same sedative effects as spinal anesthesia. Somewhat surprisingly, it is not a common clinical practice to consider that spinal cord injury patients might have lower anesthetic requirements than patients with intact spinal cord, possibly because of lack of studies directly addressing the problem.…”

Section: Introductionmentioning

confidence: 99%

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Spinal cord injury immediately decreases anesthetic requirements in rats

et al. 2011

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Study design: Pharmacologically blocking the spinal cord produces sedative effects and reduces anesthesia requirements in patients and animals. Whether spinal cord injury also reduces anesthesia requirements remains unclear. Methods: We retrospectively analyzed data from urethane-anesthetized rats 15 to assess anesthesia requirements immediately after complete thoracic transection of the spinal cord. The depth of anesthesia was monitored up to 12 h after spinal transection by the reflexes to noxious stimuli and by electrophysiological recordings from the infragranular layers of the primary somatosensory cortex. Whenever animals displayed electrophysiological and/or behavioral signs of activation, we delivered an additional dose of anesthesia. Anesthetic requirements in animals receiving spinal transection (n ¼ 11) were compared with control animals receiving 'sham' lesion (n ¼ 9). Results: The cumulative dose necessary to maintain a stable level of anesthesia was significantly lower in transected animals compared with control animals. By about 7 h after spinal cord injury, on average the cumulative dose of urethane was only 1.13 ± 0.14 of the original dose, compared with 1.64 ± 0.19 of the original dose in control animals. Conclusions: Spinal transection immediately decreased anesthetic requirements in rats. To establish whether these results are relevant for patients with spinal cord injury will require further investigation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spinal cord injury immediately decreases anesthetic requirements in rats

et al. 2011

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“…One of them attributes it to the rostral spread of the local anaesthetic agent with direct action on the brain. 21 Another theory on causes of sedative effect of neuraxial anaesthesia is the interruption of spinal afferent input with a decrease in stimulation of reticular activating system and a resultant hypnotic effect. 21 Urinary retention, another immediate postoperative complication, is associated with prolonged postoperative spinal block due to prolonged paralyzing effects on the detrusor muscles.…”

Section: Discussionmentioning

confidence: 99%

“…21 Another theory on causes of sedative effect of neuraxial anaesthesia is the interruption of spinal afferent input with a decrease in stimulation of reticular activating system and a resultant hypnotic effect. 21 Urinary retention, another immediate postoperative complication, is associated with prolonged postoperative spinal block due to prolonged paralyzing effects on the detrusor muscles. 19 The study did not reveal any incident of nausea or vomiting in the immediate postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Pethidine and bupivacaine spinal anaesthesia: a comparative evaluation of postoperative complications and recovery profile

2017

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Background: Bupivacaine is commonly used as a sole agent for spinal anaesthesia unlike Pethidine. This study compares the immediate postoperative complications and recovery profile following spinal anaesthesia with pethidine and bupivacaine.Methods: Fifty-two patients who required short duration surgical procedures below the umbilicus were randomized to receive spinal anaesthesia with pethidine 1mg/Kg and 2.5 mL 0.5% bupivacaine. Time to recovery of pin prick sensation at S2, plantar flexion, proprioception of the big toe, and full motor recovery were compared for the two agents. Complications of pain, sedation, nausea and vomiting, pruritus and urinary retention in the immediate postoperative period were also compared.Results: Comparing Pethidine and Bupivacaine, time to return of pinprick sensation at S2 was 94.62±20.25 and 205.96±31.05 minutes respectively; return of plantar flexion was 92.88±12.01 and 193.85±39.56 minutes respectively; recovery of proprioception of the big toe was 31.15±9.41 and 172.50±42.70 minutes respectively; complete motor recovery was 47.89±14.08 and 221.73±44.72 minutes respectively. All the differences in recovery times were statistically significant (p<0.0001). There was no statistically significant difference in the incidence of pain and sedation. Only 4 (15.38%) patients in the Bupivacaine group experienced mild pain. There was no incident of nausea and vomiting. However, pethidine group experienced pruritus (19.22%) and bupivacaine group none. Bupivacaine group also had urinary retention (11.54%), while pethidine group had none. These differences were statistically significant (p=0.01).Conclusions: Pethidine exhibited a shorter recovery profile than Bupivacaine and also caused no significant complication in the immediate postoperative period.

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“…(9) Eappen et al demonstrated that in rats subarachnoid bupivacaine reduced anesthetic requirements for thiopental. (10) In humans, Pollock et al reported that spinal anesthesia led to a significant decrease in BIS levels. (3) Certainly, the most profound physiological effect of spinal anesthesia is to prevent or decrease afferent input from the anesthetized body region to the reticular activating system.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the Effects of Bupivacaine and Levobupivacaine Used in Spinal Anesthesia on Propofol Requirement in BIS Guided Sedation

Şahin¹,

Kesimci²,

İzdeş³

et al. 2012

J Turk Anaesth Int Care

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SUMMARYObjective: This study was designed to compare the effects of equivalent doses of bupivacaine and levobupivacaine on propofol requirement in BIS guided sedation under spinal anesthesia.Material and Methods: Spinal anesthesia was performed on seventy patients scheduled for elective lower limb surgery with 3 mL's of either isobaric bupivacaine (Group B) or plain levobupivacaine (Group L). Five minutes after induction of spinal anesthesia, propofol infusion was started at 100 µg/kg/min and titrated to maintain bispectral index (BIS) score in the range of 65-75. Onset (to reach BIS ≤ 75) and recovery (the time from cessation of propofol infusion until BIS=90) time for sedation, and total propofol consumption during this time interval were recorded as well as time to recovery from sensory and motor block, length of stay (LOS) and sedation scores (OAA/S) in the postanesthesia care unit (PACU). Data were analyzed with One way ANOVA, Mann Whitney-U, Student's t and x 2 tests. Results: BIS was significantly decreased in Group B compared to Group L at 10 and 15 min after spinal anesthesia (p<0.01). The maximum sensory block level was higher, while time to reach maximum motor block level was shorter in Group B (p<0.05, p<0.001 respectively). Offset time of sensory and motor block, recovery time and LOS in PACU were significantly increased in Group L (p<0.05).Conclusion: Plain bupivacaine provides higher sensory block with faster onset of motor block, independent of propofol requirement as assessed by BIS monitorization. 'dan başlatılıp BİS 65-75 olacak şekilde titre edildi. Başlangıç zamanı (BİS 75'e düşünceye kadar geçen süre), derlenme süresi (propofol kesildikten BİS 90 olana kadar geçen süre), bu sırada tüketilen toplam propofol miktarı ile derlenme ünitesinde kalma süresi, sedasyon düzeyi (OAA/S), duyusal ve motor blok dönme zamanları kaydedildi. İstatistiksel analizde One way ANOVA, Mann Whitney-U, Student's t and x 2 testleri kullanıldı. Bulgular: Spinal anestezi sonrası 10. ve 15. dk.'larda BİS değerlerinin Grup B'de, Grup L'ye göre anlamlı düşük olduğu saptandı (p<0.01). Maksimum duyusal blok seviyesi Grup B'de Grup L'ye göre anlamlı yüksek, maksimum motor blok düzeyine ulaşma süresinin ise Grup L'de Grup B'ye göre anlamlı uzun olduğu belirlendi (p<0.05, p<0.001). Duyusal ve motor bloğun tam dönme süresi, derlenme süresi ve derlenmede kalış süresi Grup L'de Grup B'ye göre anlamlı olarak uzundu (p<0.05).Sonuç: Bupivakain BIS monitorizasyonu ile takip edilen sedasyonda propofol tüketiminden bağımsız olarak, yüksek duyusal blok seviyesi, erken motor blok başlangıcı sağlamaktadır.Anahtar kelimeler: spinal anestezi, lokal anestezikler, bupivakain, levobupivakain, sedatifler, propofol, sedasyon

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Effect of Subarachnoid Bupivacaine Block on Anesthetic Requirements for Thiopental in Rats

Cited by 51 publications

References 20 publications

Spinal cord injury immediately decreases anesthetic requirements in rats

Spinal cord injury immediately decreases anesthetic requirements in rats

Pethidine and bupivacaine spinal anaesthesia: a comparative evaluation of postoperative complications and recovery profile

Comparison of the Effects of Bupivacaine and Levobupivacaine Used in Spinal Anesthesia on Propofol Requirement in BIS Guided Sedation

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