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4 - The use of mixturing the local anaesthetics in the spinal anaesthesia
Ayda Başgül, Ayşe Hancı, Türkan Şanlıer
Objective: Aim of this study was to compare the onset duration of action and adverse effects of local anaesthetic mixture used in spinal anaesthesia.
Study Design: Spinal anaesthesia was applied to 17 patients, ASA 1-2 undergoing onthopaedic surgery. 4 ml 2% prilocain and 3 ml 0.5% bupivacain were used for spinal anaeshesia. Postoperative analgesic need and postoperative complications till postoperative 48 h were recorded. Data (onset of duration, motor and sensorial block time) were assessed according to standard deviation and arithmetical mean.
Results: Mean age ahr weight of patients were 40.55±15.87 years and 70.10±13.5 kg, respectively. Level of sensorial block was T 8-10 and motor block bromage 3 in all patients. Mean onset of duration was 3.831.38 min, duration of analgesia was 261.38±55.75 min, duration of motor block was 268.83±68.32 min. Peroperative complications were vomiting (n:2), nausea (n:2), shivering (n:l), hypotension (n:l), bradycardia (n:2). Six patients did not require analgesic need during the postoperative period. But 1 gr metimazol (I.M) was used for 10 patients while 20 mg proksikam (l.M) was used for one patient.
Conclusions: Onset of duration is shortened if pH of local anaesthetic is close to 7 in this study; alkalinization is made by mixturing bupivacaine and prilocaine short onset of duration and long duration of (alcalinic) mixture of drugs can be explained by their enhancement of bioavailability. Local anaesthetic mixture in spinal anaesthesia provides rapid onset of action, long duration, reduced toxisity and low postoperative analgesic consumption.
Keywords: Local anaesthetic mixture, spinal anaesthesia.
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