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Spinal Anesthesia at the L2–3 and L3–4 Levels: Comparison of Analgesia and Hemodynamic Response

Jadranka Pavičić Šarić
Simon Mikulandra
Denis Guštin
Hrvoje Matasić
Katarina Tomulić
Katarina Pavičić Dokoza

Puni tekst: engleski, pdf (97 KB) str. 151-156 preuzimanja: 287* citiraj
APA 6th Edition
Pavičić Šarić, J., Mikulandra, S., Guštin, D., Matasić, H., Tomulić, K. i Pavičić Dokoza, K. (2012). Spinal Anesthesia at the L2–3 and L3–4 Levels: Comparison of Analgesia and Hemodynamic Response. Collegium antropologicum, 36 (1), 151-156. Preuzeto s https://hrcak.srce.hr/78805
MLA 8th Edition
Pavičić Šarić, Jadranka, et al. "Spinal Anesthesia at the L2–3 and L3–4 Levels: Comparison of Analgesia and Hemodynamic Response." Collegium antropologicum, vol. 36, br. 1, 2012, str. 151-156. https://hrcak.srce.hr/78805. Citirano 13.11.2019.
Chicago 17th Edition
Pavičić Šarić, Jadranka, Simon Mikulandra, Denis Guštin, Hrvoje Matasić, Katarina Tomulić i Katarina Pavičić Dokoza. "Spinal Anesthesia at the L2–3 and L3–4 Levels: Comparison of Analgesia and Hemodynamic Response." Collegium antropologicum 36, br. 1 (2012): 151-156. https://hrcak.srce.hr/78805
Harvard
Pavičić Šarić, J., et al. (2012). 'Spinal Anesthesia at the L2–3 and L3–4 Levels: Comparison of Analgesia and Hemodynamic Response', Collegium antropologicum, 36(1), str. 151-156. Preuzeto s: https://hrcak.srce.hr/78805 (Datum pristupa: 13.11.2019.)
Vancouver
Pavičić Šarić J, Mikulandra S, Guštin D, Matasić H, Tomulić K, Pavičić Dokoza K. Spinal Anesthesia at the L2–3 and L3–4 Levels: Comparison of Analgesia and Hemodynamic Response. Collegium antropologicum [Internet]. 2012 [pristupljeno 13.11.2019.];36(1):151-156. Dostupno na: https://hrcak.srce.hr/78805
IEEE
J. Pavičić Šarić, S. Mikulandra, D. Guštin, H. Matasić, K. Tomulić i K. Pavičić Dokoza, "Spinal Anesthesia at the L2–3 and L3–4 Levels: Comparison of Analgesia and Hemodynamic Response", Collegium antropologicum, vol.36, br. 1, str. 151-156, 2012. [Online]. Dostupno na: https://hrcak.srce.hr/78805. [Citirano: 13.11.2019.]

Sažetak
Aim of this study was to evaluate level of analgesia and hemodynamic response to spinal anesthesia obtained by administering 15 mg 0.5% isobaric bupivacaine at L2–3 vs. L3–4 interspace for inguinal herniorrhaphy, since studies comparing analgesia and hemodynamic response at the L2–3 vs. L3–4 interspaces are lacking. In a prospective, randomized clinical study that encountered 72 patients undergoing elective inguinal herniorrhaphy randomly allocated in to two equal groups L2–3 (N=36) and L3–4 (N=36) according to lumbar interspace where intrathecal injection of bupivacaine was administered. Analgesia was evaluated by intraoperative »rescue« fentanyl requirements, the absence of pain and the maximal visual analogue scale (VAS) scores reached per patient during the operation. The severity of intraoperative pain was quantified by a 10 cm VAS scale (VAS 0: no pain to 10: worst pain imaginable) every 5 minutes after skin incision until the end of the operation. VAS>3 was treated with intravenous fentanyl 25 μg. Hemodynamic response was monitored and evaluated, heart rate was continuously monitored as well as, baseline systolic, diastolic and mean arterial pressure prior to induction and every 5 minute after applying spinal anesthesia until surgical completion. Intraoperative fentanyl requirements were significantly higher in group L3–4 (L2–3 0%, 97.5% confidence interval [CI] 0.0–0.11 vs. L3–4 17%, 95% CI 0.07–0.32, p=0.025). Absence of pain was significantly higher in L2–3 group at the beginning of the operation (L2–3 89%, 95% CI 0.74–0.96 vs. L3–4 67%, 95% CI 0.50–0.79, p=0.047). The maximal VAS scores reached per patient during the operation in L2–3 group were lower then in L3–4 group (L2–3 median [M] 0, range [R] 0–3, L3–4 M 0, R 0–8, p=0.014). There were no significant differences (p>0.05) in the incidence of hypotension (L2–3 19%, 95% CI 0.09–0.35 vs. L3–4 17%, 95% CI 0.07–0.32) and bradycardia (L2–3 19%, 95% CI 0.09–0.35 vs. L3–4 8%, 95% CI 0.02–0.23). Spinal anesthesia with isobaric bupivacaine administered in L2–3 interspace for inguinal herniorrhaphy provides superior analgesia and equal hemodynamic stability as compared to neuroaxial anesthesia administered in the L3–4 interspace.

Ključne riječi
anesthesia; spinal; analgesia; hypotension; bradycardia

Hrčak ID: 78805

URI
https://hrcak.srce.hr/78805

Posjeta: 543 *