Influence of the Lumbar Interspace Chosen for Injection on the Spread of Hyperbaric 0.5% Bupivacaine

Low vs High Dose Spinal Hyperbaric Bupivacaine on Hemodynamic Variables in Patients Undergoing Transurethral Resection of the Prostate: A Prospective Two Arm Open Label Randomised Comparative Study

“…Reducing by half the quantity of the drug injected does not reduce by half the number of segments blocked. 16,17 This hypothesis is confirmed by Burgess et al 12 about continuous spinal anesthesia and the efficiency of 3.75 mg and 5 mg hyperbaric bupivacaine, in peripheral vascular surgery.…”

“…11 The lumbar interspace chosen for injection of hyperbaric bupivacaine may influence the level of the block. 12 All patients in our study, had the anesthetic solution injected in the L3-L4 interspace with the same velocity and the orifice of the spinal needle turned cephalad.…”

Conus medullaris trauma: is there a greater risk in parturients?

“…In a similar study by Lowson et al using bupivacaine, the onset of anaesthesia at T10 and T6 was faster following injection at the higher interspace, although the final sensory level was not different [10]. The higher extent of the upper sensory block may explain why anaesthetists often prefer to perform spinal anaesthesia at a higher interspace, which is often anatomically easier than at lower levels.…”

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

“…In contrast, heavy solutions remain hyperbaric before and after spinal injection with negligible effects on the intrathecal drug distribution [9]. Second, a procedure effect such as higher levels of injection, may cause more cephalad spread with plain bupivacaine [11][12][13] but has little effect on the spread of the heavy solution [14][15][16]. Since it is di cult to accurately identify the interspace for injection [17], the use of a hyperbaric solution will minimize the in uence of any inaccuracy at the injection site.…”