Comparison of hemodynamic effects of hyperbaric and isobaric bupivacaine in spinal anesthesia.
BACKGROUND
Spinal anesthesia presents reversible interruption of nerve transmission within subarachniod space produced by injection of local anesthetic in cerebrospinal fluid. At the same time it comes to the blockade of particular functions of the nerve transmission. At the focus of this work is the blockade of sympathetic fibres which significantly affect on the behavior of the hemodynamic parameters. Change of these parameters may be very emphasized. One of the possible factors which may implicate is baricity of spinal anesthetic. The goals of the work are to determine how does the baricity affect the behavior of the basic hemodynamic parameters and also the height and distribution of the sensory block.


METHODS
The research has been made on two groups who were given the same amount of 0.5% bupivacaine of different baricity; to the first group hyperbaric with 8.25% glucose and to the second an isobaric without any additives. At that time the application has been made on the same vertebral level, in same position. The research has been made on the patients in Hospital "Dr Irfan Ljubijankic" in Bihac.


RESULTS
In hyperbaric group, systolic, mean, diastolic blood pressure and pulse frequency decreased 19.41%, 18.75%, 17.54% and 10.26% respectively, significantly greater than in isobaric group (7.22%, 2.65%, 1.62% and 9.38%). Gained results with high statistic significancy show that the baricity have an essential effect on the behavior of the basic hemodynamic parameters in the sense of reduction of the arterial blood pressure and slowing down of the pulse. At the same time isobaric anesthetic give smaller deviation of the parameters.


CONCLUSIONS
By choosing the anesthetics of the appropriate baricity we can significantly affect hemodynamic status of the patient.
Solakovic
Nedim
N
Department for Anesthesiology, Reanimation and Intensive Care, Cantonal Hospital "Dr Irfan Ljubijankic", Bihac, Bosnia and Herzegovina. dr_nedim@yahoo.com
D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D002045:Bupivacaine / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011674:Pulse
D000779:Anesthetics, Local; D002045:Bupivacaine