title: Addition of lidocaine to levobupivacaine reduces intrathecal block duration: randomized controlled trial.
abstract: BACKGROUND
  The duration of the spinal block is a concern for anesthetists. Low dose intrathecal lidocaine has vasodilatory effects and increases the local anesthetic clearance from the intrathecal space. The aim was to investigate whether this effect of lidocaine can be used to increase the resolution of levobupivacaine spinal anesthesia.
  
  
  METHODS
  After obtaining ethical approval and informed patient consent, 40 patients underwent transurethral prostate resection were studied. Patients were randomized into two groups and patients received either levobupivacaine 6.75 mg + 0.3 mL 2% lidocaine (Group L) or levobupivacaine 6.75 mg + saline (Group C). The main outcome measures were the difference between groups regarding the duration of the spinal block and PACU stay. Secondary outcome measures were the difference between groups in onset and resolution of the spinal block, adverse events and treatments were also investigated.
  
  
  RESULTS
  Spinal block resolved faster in Group L than Group C; 162.43±39.4 min vs 219.73 ± 37.3 min (p = 0.000). PACU time was shorter in Group L (109 ± 49.9 min in Group L vs 148 ± 56.8 min in Group C) (p = 0.036). There was no difference between groups with respect to the incidence of adverse events and treatments. Groups were also similar regarding complications. PDPH and TNS were not observed in any group.
  
  
  CONCLUSIONS
  Addition of low dose lidocaine to hyperbaric levobupivacaine reduces the duration of the intrathecal block provided by hyperbaric levobupivacaine. This technique can be used to reduce the spinal block duration for relatively short procedures like TUR-P.
authors.affiliation: Ankara Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey. Electronic address: dilek.yazicioglu@hotmail.com.
authors.forename: Dilek
authors.initials: D
authors.lastname: Yazicioglu
authors.affiliation: Ankara Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Taylan
authors.initials: T
authors.lastname: Akkaya
authors.affiliation: Ankara Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Sonmez
authors.affiliation: Ankara Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Haluk
authors.initials: H
authors.lastname: Gumus
mesh_terms: D000368:Aged; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004359:Drug Therapy, Combination; D006801:Humans; D007278:Injections, Spinal; D000077554:Levobupivacaine; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D000077554:Levobupivacaine; D002045:Bupivacaine
keywords: Levobupivacaine; Lidocaine; Spinal anesthesia; TUR-P