[Evaluation of abdominal motor blockade using surface integrated electromyography during bupivacaine spinal anesthesia].
The study was undertaken to investigate abdominal motor blockade and compare sensory-motor differential blockade in bupivacaine spinal anesthesia by surface integrated electromyography (SIEMG). Seventeen physical status I adult male patients underwent lower limb surgery under spinal anesthesia were divided into two groups: hyperbaric bupivacaine (HB) group (n = 8) receiving 3 mL of 0.5% bupivacaine (8% glucose) and isobaric bupivacaine (IB) group (n = 9), 3 mL of 0.5% bupivacaine (glucose-free). Each patient was monitored with a blood pressure cuff, an ECG and a precordial stethoscope. Spinal anesthesia was performed at L3-4 interspace on the lateral position. Immediately following injection of bupivacaine, the patients were turned to the supine position and then simultaneous measurements of sensory blockade using pinprick, abdominal motor blockade at T6, T8, T10, T12 level using SIEMG and lower limb motor blockade using Bromage scale were made for 4 hours. Between two groups, there were no significant differences in terms of age, body weight, height as maximum level and mean times to maximum level of sensory blockade, abdominal motor blockade and lower limb motor blockade. The times of 2-segment regression of sensory blockade were 66.3 +/- 11.1 min in HB group and 115.6 +/- 31.3 min in IB group. The sensory-motor differential blockades were 4.6 +/- 0.5 segments and 4.8 +/- 2.1 segments in HB and IB groups, respectively. According to the linear regression analysis, the correlation between sensory blockade and abdominal motor blockade was better than the lower limb motor blockade and abdominal motor blockade. (Correlation coefficient (r): 0.893 vs 0.580 in HB group; 0.773 vs 0.366 in IB group).(ABSTRACT TRUNCATED AT 250 WORDS)
Cherng
C H
CH
Department of Anesthesiology, and Pharmacy, National Defense Medical Center.
Ho
S T
ST
Hu
O Y
OY
Hwang
Y C
YC
D000005:Abdomen / Q000294:innervation*; D000328:Adult; D000775:Anesthesia, Spinal; D002045:Bupivacaine; D004576:Electromyography / Q000379:methods; D006801:Humans; D008297:Male; D009046:Motor Neurons / Q000187:drug effects* / Q000502:physiology; D009475:Neurons, Afferent / Q000187:drug effects / Q000502:physiology; D012044:Regression Analysis
D002045:Bupivacaine