title: Fast glycorrhachia and cerebrospinal fluid protein as predictors of sensory block in anesthesia with subarachnoid Ropivacaine.
abstract: BACKGROUND
  Identify if glycorrhachia and cerebrospinal fluid protein could influence the time of sensory block to T10, the duration and the metameric block's level, after a standard dose of Ropivacaine.
  
  
  METHODS
  80 patients, ASA I - III undergoing to transurethral prostate resection with spinal anesthesia in a prospected open study were recruited. A 0.2 ml liquor's sample was taken; glycorrhachia, by glycemic stix and CSF protein, by urinary stix, were got, before Ropivacaine 0.5% 15 mg injection (0.10 - 0.15 mlsec). After anti-trendelemburg, with 30 ° tilting for 15 min, the onset of sensory block to T10, the maximum metameric level to 15' and the time of sensory block were reported. The data collection were analyzed using the software language R.
  
  
  RESULTS
  A significant correlation liquor specific weigh preoperative glycemia (0.749), liquoral specific weigh glycorrhachia (rho = 0.751; R2 = 0.564; P 0.05) and specific weigh CSF protein (rho = 0.684; R2 = 0.468; P 0.05) were reported. Inverse relation CSF weightsensory block level (rho -0.789, P 0.05, R2 0.621) was evidenced. Inverse relation onset time to T10 glycorrhachia (84%) and cephalic block glycorrhachia (76%) were found. Inverse correlation onset time to T 10 CSF protein and cephalic block proteinorrachia was respectively 84% and 67%. A rho of 0.712 with R2 of 51% BMI onset to T10 and rho of 0.681 with R2 of 51% BMI maximum cephalic block with P 0.05 were reported.
  
  
  CONCLUSIONS
  The predictability of a iso-hypobaric local anesthetic could reduce the risk of procedure failure and adverse events by further cephalic spread.
authors.affiliation: Department of Medical Surgical Sciences and Translational Medicine Sant'Andrea Hospital Sapienza University of Rome.
authors.forename: S
authors.initials: S
authors.lastname: Collini
authors.affiliation: Sant'Andrea Hospital of Rome.
authors.forename: F
authors.initials: F
authors.lastname: Troisi
authors.affiliation: Department of Organs of Sense, Sapienza University of Rome.
authors.forename: F
authors.initials: F
authors.lastname: Pacella
authors.affiliation: Sant'Andrea Hospital of Rome.
authors.forename: P
authors.initials: P
authors.lastname: Merlin
authors.affiliation: Research Unit of Occupational Medicine, Sapienza University of Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: De Sio
authors.affiliation: Department of Organs of Sense, Sapienza University of Rome.
authors.forename: E
authors.initials: E
authors.lastname: Pacella
mesh_terms: D000577:Amides / Q000008:administration & dosage / Q000134:cerebrospinal fluid*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000772:Anesthesia, Local / Q000379:methods; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000134:cerebrospinal fluid*; D002045:Bupivacaine / Q000134:cerebrospinal fluid*; D002556:Cerebrospinal Fluid Proteins / Q000008:administration & dosage / Q000134:cerebrospinal fluid*; D005260:Female; D005947:Glucose / Q000134:cerebrospinal fluid*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000077212:Ropivacaine; D012677:Sensation / Q000187:drug effects*
chemical_list: D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D002556:Cerebrospinal Fluid Proteins; D000077212:Ropivacaine; D005947:Glucose; D002045:Bupivacaine
keywords: Cerebrospinal fluid (CSF) protein; Glycorrhachia; Ropivacaine; Spinal; Subarachnoid anesthesia