Low hypobaric bupivacaine doses for unilateral spinal anesthesia.
OBJECTIVE
The possibility to achieve unilateral spinal anesthesia with 0.15% bupivacaine was studied with the purpose of minimizing hemodynamic changes, limiting the cephalad dispersion of the anesthetic and promoting a faster recovery.


METHODS
Twenty ASA I - II patients undergoing orthopedic surgeries were given spinal 0.15% hypobaric bupivacaine through a 27G Quincke needle. Dural puncture was performed with patients in the lateral position, with the limb to be operated upwards, and 3.3 ml (5 mg) hypobaric bupivacaine were injected at the rate of 1 ml.15 s(-). Sensory and motor block (pinprick and 0 to 3 scale) were compared between operated and contralateral sides.


RESULTS
Motor and sensory block in operated and contralateral sides were significantly different in all evaluated times. Unilateral spinal anesthesia was achieved in 75% of patients. All patients remained hemodynamically stable, and no one developed post-dural puncture headache.


CONCLUSIONS
Hypobaric bupivacaine (5 mg) is able to provide a predominant unilateral block with the patient being kept twenty minutes in the lateral position. Major unilateral spinal anesthesia advantage is hemodynamic stability.
Imbelloni
Luiz Eduardo
LE
Casa de Saúde Santa Maria, Clínica São Bernardo e Hospital do IASERJ, Rio de Janeiro, RJ. imbelloni@openlink.com.br
Beato
Lúcia
L
Gouveia
M A
MA