The effectivness and simpthoms of spinal anaesthesia depending on the influence of the applied local anaestetic

Abstract

Sažetak:Cilj studije bio je da se uporedi kvalitet spinalnog bloka, stanje bolesnika tokom spinalne anestezije i pojava neželjenih efekata kod bolesnika koji su intratekalno primili različite količine rastvora 0,5% levobupivakaina. Metode: Studijom je obuhvaćeno 40 bolesnika, American Society of Anaesthesiologists (ASA) I do IV, koji su, radi izvođenja hirurške intervencije, bili podvrgnuti spinalnoj anesteziji. Bolesnici su bili podeljeni u dve grupe: grupa A (grupa koja je primila veći volumen) i grupa B (grupa koja je primila manji volumen). Monitoring je obuhvatao kontinuirano praćenje EKG-a, srčane frekvence, krvnog pritiska i saturacije kiseonikom. Rezultati: Prospektivnom studijom obuhvaćeno je 40 bolesnika, 24 (60%) muškarca i 16 (40%) žena. Među grupama nije bilo statistički značajne razlike prema godinama starosti i ASA statusu bolesnika. Nastanak i razvoj bradikardije bio je u statistički značajnoj korelaciji sa porastom doze aplikovanog lokalnog anestetika (p<0,001). Hipotenzija, bledilo kože, znojenje i mučnina opisani su samo u grupi bolesnika koji su primili veće doze lokalnog anestetika. Nije nađena statistički značajna razlika u uspešnosti spinalnog bloka zavisno od doze aplikovanog leka. Zaključak: Među grupama nije nađena statistički značajna razlika dozne zavisnosti uspešnosti spinalnog bloka. Incidenca neželjenih efekata bila je srazmerna količini datog anestetika. Ključne reči:spinalna anestezija, levobupivakain, toksičnost. Summary:The aim of the present study was to compare the anaesthesia quality, patient comfort and complications during spinal anaesthesia in patients who received less volume of the local anaesthetic (1.5ml and 2.0 ml) and patients with higher volumes intrathecally injected local anaesthetic (3.5ml and 4.0 ml) 0.5 % solution levobupivacaine. Materials and methods: The study involved 40 patients, ASA I to IV who were scheduled to have elective surgery with spinal anaesthesia. The patients were divided in two groups: Group A (the group received higher volume) and Group B (the group received less volume). The heart rate, non-invasive blood pressure and SpO2 were recorded before spinal anaesthesia and on 5 minutes during the surgery. Results: There were no significant differences between the two groups with respect to age and ASA patient status. The onset and progress of Bradycardia was in a significant statistical correlation with the dose of the local anaesthetic (p<0,001). The complications and side effects of spinal anaesthesia techniques, such as nausea, vomiting, headache were frequentl in the group with higher dose of local anaesthetic. Conclusion: There were no statistically significant discrepancies related to the success of the spinal block with respect to the dose of the applied anaesthetic. The incidence of sideeffects was proportional to the dose of the applied anaesthetic.