DIFFERENCES IN THE LEVEL OF TEMPERATURE, SENSORY, AND MOTOR BLOCKADES WHEN PERFORMING CONVENTIONAL AND UNILATERAL SPINAL ANESTHESIAS
https://doi.org/10.21292/2078-5658-2015-12-1-29-33
Abstract
Under spinal anesthesia, different types of nerve fibers forming spinal nerve roots are unequally blocked. Objective: to estimate differences in the development of temperature, sensory, and motor blockades when performing different procedures of spinal anesthesia. This prospective study covered 70 patients undergoing different operations. In accordance with the procedure of spinal anesthesia, the patients were divided into classical (n = 35) and unilateral spinal anesthesia (n = 35) groups. The performed study has indicated that blockade of temperature fibers occurs, and first, next is that of sensory neurons, and at last motor ones. The latent period of temperature blockade is about 1 min and that is an early predictor of evolving sensory block. At all stages and under traditional and unilateral spinal anesthesias, the width of temperature blockade was 1–2 segments higher than that of sensory blockade. The lower bupivacaine dosage used with the unilateral procedure gave rise to even greater block differentiation. Sensory anesthesia developed more slowly, but motor blockage did fully in not all cases.
About the Author
R. E. Lakhin
ФГБВОУ ВПО «Военно-медицинская академия имени С. М. Кирова», г. Санкт-Петербург
Russian Federation
Russian Federation
References
1. Горбачев В. И., Маньков А. В. Оптимизация спинномозговой анестезии в хирургии межпозвонковых дисков // Общ. реаниматол. - 2006. - № 5-6. - С. 178-183.
2. Жарников А. В. Частичная сегментарная анестезия у пациентов старших возрастных групп // Якут. мед. ж. - 2012. - Т. 3, № 39. - С. 24-27.
3. Инструкция по применению лекарственного препарата для медицинского применения Маркаин Спинал Хэви. http://www.astrazeneca.ru, 05 12 2007. [В Интернете]. Available: http://www.astrazeneca.ru/medicines/anaesthesiology. [Дата обращения: 23.09.2014].
4. Маньков А. В., Павлюк А. Л., Евсеев Б. К. Гемодинамические осложнения нейроаксиальной анестезии // Сиб. мед. ж. - 2009. - Т. 90. -С. 19-22.
5. Brull S. J., Greene N. M. Time-Courses of zones of differential sensory blockade during spinal anesthesia with hyperbaric tetracaine or bupivacaine // Anesthesia & Analgesia. - 1989. - Vol. 69, № 3. - P. 342-347.
6. Casati A., Fanelli G., Cappelleri G. et al. Does speed of intrathecal injection affect the distribution of hyperbaric bupivacaine? // Br. J Anaesth. - 1998. - Vol. 81. - P. 355-357.
7. Gasser H. S., Erlanger J. Role of size in establishment of nerve block by pressure or cocaine // Am. J. Physiol. - 1929. - Vol. 88. - P. 581-589.
8. Grover B. A., Rush J. M., Servoss M. M. Assessing sensory blockade with alcohol and pinprick after subarachnoid block // AANA J. - 1998. - Vol. 66, № 1. - P. 77-81.
9. Hocking G., Wildsmith J. A. W. Intrathecal drug spread // Brit. J. Anaesthesia. - 2004. - Vol. 93. - P. 568-578.
10. Kocarev M., Watkins E., McLure H. et al. Sensory testing of spinal anaesthesia for caesarean section: differential block and variability // Int. J. Obstetric Anesthesia. - 2010. - Vol. 19, № 3. - P. 261-265.
11. Liu S., Kopacz D. J., Carpenter R. L. Quantitative assessment of differential sensory nerve block after lidocaine spinal anesthesia // Anesthesiology. - 1995. - Vol. 82, № 1. - P. 60-63.
12. Liu S., Ware P. Differential sensory block after spinal bupivacaine in volunteers // Anesthesia & Analgesia. - 1997. - Vol. 84, № 1. - P. 115-119.
13. Ousley R., Egan C., Dowling K. et al. Assessment of block height for satisfactory spinal anaesthesia for caesarean section // Anaesthesia. - 2012. - Vol. 67. - P. 1356-1363.
14. Russell I. F. A comparison of cold, pinprick and touch for assessing the level of spinal block at caesarean section // Int. J. Obstetric Anesthesia. - 2004. - Vol. 13. - P. 146-152.
Review
For citations:
Lakhin R.E. DIFFERENCES IN THE LEVEL OF TEMPERATURE, SENSORY, AND MOTOR BLOCKADES WHEN PERFORMING CONVENTIONAL AND UNILATERAL SPINAL ANESTHESIAS. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2015;12(1):29-33. (In Russ.) https://doi.org/10.21292/2078-5658-2015-12-1-29-33
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