Continuous spinal anesthesia: dose requirements and characteristics of the block.
OBJECTIVE
A fine-bore 28G CoSpan spinal catheter was used to provide continuous spinal anesthesia for major upper and lower abdominal, peripheral vascular, and orthopedic surgery in 90 patients, aged 31-91 years.


METHODS
Initial doses (0.5-2.0 mL) of hyperbaric bupivacaine 0.5% were given and followed, if needed, by additional doses of 0.5-1.0 mL to achieve a satisfactory blockade for the proposed type of surgery. The incidence of hypotension, ambulatory postdural puncture headache, and technical problems encountered with insertion of the spinal catheters were recorded.


RESULTS
The technique of continuous spinal anesthesia was successful and easy to learn. Satisfactory sensory and motor blockade was achieved within 12-18 minutes, and surprisingly small amounts were needed in those patients undergoing limb surgery.


CONCLUSIONS
Mild postdural puncture headache occurred in four patients, but none of the patients required blood patch. One catheter broke during removal; since then, it has been our policy to remove a catheter with the patient in a flexed position.
Petros
A J
AJ
Department of Anesthesia, Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex, United Kingdom.
Barnard
M
M
Smith
D
D
Ronzoni
G
G
Carli
F
F
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002045:Bupivacaine; D002404:Catheterization; D004305:Dose-Response Relationship, Drug; D006261:Headache / Q000139:chemically induced / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000139:chemically induced / Q000209:etiology; D015994:Incidence; D008875:Middle Aged; D009407:Nerve Block
D002045:Bupivacaine