title: Does speed of intrathecal injection affect the distribution of 0.5% hyperbaric bupivacaine?
abstract: We have evaluated the influence of speed of intrathecal injection on lateral distribution of 0.5% hyperbaric bupivacaine. We studied 60 patients undergoing lower limb surgery who were placed in the lateral position with the operative side in the dependent position. After dural puncture (25-gauge Whitacre spinal needle), the needle aperture was turned towards the dependent side and 0.5% hyperbaric bupivacaine 8 mg was injected randomly at a rate of 0.02 ml s-1 (group slow, n = 30) or 0.25 ml s-1 (group fast, n = 30). Lateral position was maintained for 15 min while a blinded observer recorded loss of pinprick sensation and degree of motor block on both surgical and non-surgical sides. There were no differences between the groups. Forty-five minutes after patients were turned to the supine position, spinal anaesthesia was unilateral in 17 patients in group slow (56%) and in 13 patients in group fast (43%). We conclude that using extremely low speeds for intrathecal injection were not clinically advantageous in obtaining unilateral spinal anaesthesia.
authors.affiliation: University of Milan, Department of Anaesthesiology, IRCCS H San Raffaele, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Casati
authors.forename: G
authors.initials: G
authors.lastname: Fanelli
authors.forename: G
authors.initials: G
authors.lastname: Cappelleri
authors.forename: A
authors.initials: A
authors.lastname: Leoni
authors.forename: M
authors.initials: M
authors.lastname: Berti
authors.forename: G
authors.initials: G
authors.lastname: Aldegheri
authors.forename: G
authors.initials: G
authors.lastname: Torri
mesh_terms: D000328:Adult; D000368:Aged; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000187:drug effects; D011446:Prospective Studies; D012677:Sensation / Q000187:drug effects
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine