title: The comparison of levobupivacaine in continuous or single dose spinal anesthesia for transurethral resection of prostate surgery.
abstract: BACKGROUND
  The aim of the study is to compare the efficacy of levobupivacaine induced continuous spinal anesthesia (CSA) versus single dose spinal anesthesia (SDSA) in patients who are planned to undergo transurethral prostate resection.
  
  
  METHODS
  Sixty years or older, ASA I-II or III, 50 patients were included in the study. 12.5mg 0.5% levobupivacaine were administered intrathecally in SDSA group. In CSA group, initially 2mL of 0.25% levobupivacaine were administered through spinal catheter. In order to achieve sensory block level at T10 dermatome, additional 1mL of 0.25% levobupivacaine were administered through the catheter in every 10min. Hemodynamic parameters and block characteristics were recorded. Preoperative and postoperative blood samples of the patients were drawn to determine plasma cortisone and plasma epinephrine levels.
  
  
  RESULTS
  CSA technique provided better hemodynamic stability compared to SDSA technique particularly 90min after intrathecal administration. The rise in sensory block level was rapid and the time to reach surgical anesthesia was shorter in SDSA group. Motor block developed faster in SDSA group. In CSA group, similar anesthesia level was achieved by using lower levobupivacaine dose and which was related to faster recovery. Although, both techniques were effective in preventing surgical stress respond, postoperative cortisone levels were suppressed more in SDSA group.
  
  
  CONCLUSIONS
  CSA technique with 0.25% levobupivacaine can be used as a regional anesthesia method for elderly patients planned to have TUR-P operation.
authors.affiliation: Clinic of Anesthesiology Sani Konukoğlu Hospital, Gaziantep, Turkey.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Baydilek
authors.affiliation: Department of Anesthesiology and Reanimation, Bulent Ecevit University, Zonguldak, Turkey. Electronic address: syurtlu68@gmail.com.
authors.forename: Bülent Serhan
authors.initials: BS
authors.lastname: Yurtlu
authors.affiliation: Department of Anesthesiology and Reanimation, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
authors.forename: Volkan
authors.initials: V
authors.lastname: Hanci
authors.affiliation: Department of Anesthesiology and Reanimation, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Ayoğlu
authors.affiliation: Department of Anesthesiology and Reanimation, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Rahşan Dilek
authors.initials: RD
authors.lastname: Okyay
authors.affiliation: Department of Anesthesiology and Reanimation, Inonü University, Zonguldak, Turkey.
authors.forename: Gulay Erdoğan
authors.initials: GE
authors.lastname: Kayhan
authors.affiliation: Department of Urology, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Hüsnü
authors.initials: H
authors.lastname: Tokgöz
authors.affiliation: Department of Biochemistry, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Görkem
authors.initials: G
authors.lastname: Mungan
authors.affiliation: Department of Anesthesiology and Reanimation, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Işıl
authors.initials: I
authors.lastname: Ozkoçak
mesh_terms: D000368:Aged; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D020728:Transurethral Resection of Prostate / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine
keywords: Continuous spinal anesthesia; Levobupivacaine; Spinal anesthesia; Transurethral prostate resection