Hyperbaric levobupivacaine in anal surgery

Kazak, Züleyha; Ekmekçi, Perihan Elif; Kazbek, K.

doi:10.1007/s00101-010-1755-1

Cited by 16 publications

(3 citation statements)

References 17 publications

(12 reference statements)

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“…Their patients did not have any motor blockade. [ 15 ] In our study, 6 mg of hyperbaric bupivacaine was used and the patients were made to sit only for 5 min due to constraints related to operation theatre time management which led to a prolonged motor blockade. Furthermore, the time to ambulation and time to micturition were prolonged in the dexmedetomidine group.…”

Section: Discussionmentioning

confidence: 99%

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Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study

et al. 2015

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Background and Aim:The newer trend in regional anaesthesia for ambulatory anorectal surgeries advocate use of lower dose of local anaesthetic, providing segmental block with adjuvants such as opioids and α2 agonists to prolong analgesia. The current study investigated effects of addition of 5 μg of dexmedetomidine to 6 mg of hyperbaric bupivacaine on duration of analgesia, sensory and motor block characteristics for perianal ambulatory surgeries.Methods:This study is a prospective randomised controlled double blind study. Forty adult patients between 18 and 55 years of age were divided into 2 groups. Group D received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml) with injection dexmedetomidine 5 μg in 0.5 ml of normal saline and Group N received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml) with 0.5 ml of normal saline. The parameters assessed were time to regression of sensory blockade, motor blockade, ambulation, time to void, first administration of analgesic. Statistical analysis was done using appropriate tests.Results:Time for regression of sensory level and time for first administration of analgesic were prolonged in Group D (430.05 ± 89.13 min, 459.8 ± 100.9 min, respectively) in comparison to Group N (301.10 ± 94.86 min, 321.85 ± 95.08 min, respectively). However, the duration of motor blockade, time to ambulation, and time to void were also significantly prolonged in Group D (323.05 ± 54.58 min, 329.55 ± 54.06 min, 422.30 ± 87.59 min) than in Group N (220.10 ± 63.61 min, 221.60 ± 63.84 min, 328.45 ± 113.38 min).Conclusion:Intrathecal dexmedetomidine 5 μg added to intrathecal bupivacaine 6 mg as adjuvant may not be suitable for ambulatory perianal surgeries due to prolongation of motor blockade.

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Section: Discussionmentioning

confidence: 99%

“…The incidence of nausea and vomiting was lower in the dexmedetomidine group, even though it was not statistically significant in concurrence with all the previous published studies. [ 9 10 11 12 13 14 15 16 17 18 ]…”

Section: Discussionmentioning

confidence: 99%

Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study

et al. 2015

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“…However, the issue of how to determine the optimal anesthetic dose is still one of the most important questions. Different local anesthetics in different volumes are used in the saddle block, which is stated to be safe to be used in studies [4,7,15]. Patterson et al [7] used 2.5-5 mg of hyperbaric local anesthetic in a large-series cohort study they conducted and stated that an analgesic effect was achieved for one to three hours depending on the half-life of the local anesthetic.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Different Local Anesthetic Volumes for Saddle Block Anesthesia in Ambulatory Surgery: A Prospective Randomized Trial

Zengin,

Yalnız,

Başkan

et al. 2023

Cureus

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Introduction: Saddle block anesthesia (SBA) is a frequently preferred method for ambulatory anorectal surgery. This study aimed to observe the effects of two different dose SBAs on discharge times and perioperative block characteristics in patients undergoing ambulatory anorectal surgery.Methods: The study was conducted as a prospective, randomized controlled study. Patients over the age of 18 who were scheduled for ambulatory anorectal surgery and had American Society of Anaesthesiologists (ASA) physical status I and II were included in the research. Patients were divided into two groups: 5 mg hyperbaric bupivacaine 0.5% (Group I; n=34) and 3 mg hyperbaric bupivacaine 0.5% (Group II; n=34). The primary outcome was discharge time. Characteristics of the spinal block like time to reach S4 blockade, maximum blocked dermatome, regression time of sensorial, first analgesic need time, voiding time, mobilization time, and side effects were the secondary outcomes.Results: Sixty-eight patients were included in the study. The groups were similar in terms of demographic and surgical characteristics (p > 0.05). In Group II, S4 sensory dermatome blockade time was statistically longer (p: 0.007) and the time to the disappearance of the sensory block was statistically shorter (p < 0.001). Also, voiding time and discharge times were statistically shorter in Group II (p: 0.049, p < 0.001, respectively). Conclusion: SBA provided adequate anesthesia, and the complication rates were limited. Saddle block can be considered an advantageous technique because of conditions that adversely affect recoveries, such as postoperative cognitive problems, nausea, and vomiting due to general anesthesia. In addition, better recovery results and optimal surgical condition with 3 mg hyperbaric bupivacaine in our study suggest that this dose may be a good alternative.

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Ultrasound in Neuraxial and Perineuraxial Blocks

Eisenberg

Gaertner

2023

Ultrasound in Peripheral, Neuraxial and Perineuraxial Regional Anaesthesia

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Hyperbaric levobupivacaine in anal surgery

Abstract: The results of the study showed that the use of 1.5 mg hyperbaric levobupivacaine provides sufficient and satisfactory anesthesia in ambulatory perianal surgery.

Cited by 16 publications

References 17 publications

Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study

Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study

Comparison of Different Local Anesthetic Volumes for Saddle Block Anesthesia in Ambulatory Surgery: A Prospective Randomized Trial

Ultrasound in Neuraxial and Perineuraxial Blocks

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