Spinal anaesthesia with 0.5% isobaric bupivacaine in patients with diabetes mellitus: the influence of CSF composition on sensory and motor block.
OBJECTIVE
We investigated cerebrospinal fluid characteristics in patients with and without diabetes mellitus and the influences that changes in these characteristics have on sensory and motor block when spinal anaesthesia is performed.


METHODS
We included 44 patients in each study group. All received spinal administration of 15 mg of 0.5% isobaric bupivacaine. Blood and cerebrospinal fluid were analysed for glucose, total protein, urea, albumin, immunoglobulin G, sodium, chloride, potassium, calcium, magnesium and osmolarity as well as the performance of the local anaesthetic from establishment until complete regression of sensory and motor block.


RESULTS
The cerebrospinal fluid of the two groups differed significantly (P < 0.05) in the levels of total protein, albumin, immunoglobulin G, glucose and osmolarity. Sensory and motor block was established more rapidly in the diabetic group (P < 0.05), and the total duration from maximum block until regression to two dermatomes was greater (P < 0.05), as was the complete regression from sensory and motor block (P < 0.05).


CONCLUSIONS
This study shows that diabetes mellitus has an influence on sensory and motor block after the administration of spinal isobaric bupivacaine.
Echevarria
M
M
Valme University Hospital, Departament of Anaesthesiology, Seville, Spain. MERCEDES.ETXEBA@terra.es
Hachero
A
A
Martinez
A
A
Ramallo
E
E
García-Bernal
D
D
Ramos
M
M
Fernández
A
A
D000328:Adult; D000368:Aged; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D002555:Cerebrospinal Fluid / Q000737:chemistry*; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D003920:Diabetes Mellitus / Q000134:cerebrospinal fluid; D017558:Elective Surgical Procedures; D004573:Electrolytes / Q000097:blood / Q000134:cerebrospinal fluid; D005260:Female; D005947:Glucose / Q000032:analysis / Q000134:cerebrospinal fluid; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D009994:Osmolar Concentration; D011446:Prospective Studies; D012677:Sensation / Q000187:drug effects; D016896:Treatment Outcome
D000779:Anesthetics, Local; D002556:Cerebrospinal Fluid Proteins; D004573:Electrolytes; D007074:Immunoglobulin G; D005947:Glucose; D002045:Bupivacaine