Spinal Anesthesia, Success or Failure of Spinal Anesthesia
Conditions
Keywords
Spinal anesthesia, determinant, duration
Brief summary
In these prospective observational study, the investigators are trying to evaluate (1) the influence of body-mass index on spinal anesthetic outcome and (2) the determinants on spinal anesthetic outcome by logistic regression analysis.
Detailed description
Although the spread of spinal anesthetic drug is unpredictable, patients factors (age, gender, height,weight, body-mass index), spinal anatomy, anesthetic drug dose, and lumbosacral cerebrospinal fluid volume are known to be the determinants of sensory block level. Among these determinants, the influence of body-mass index (BMI) on spinal anesthesia is controversial, and there is no specific guideline showing the relative priority of these determinants. Therefore, in these prospective observational study, the investigators are trying to evaluate (1) the influence of body-mass index on spinal anesthetic outcome and (2) the relative influence of these determinants on spinal anesthetic outcome by logistic regression analysis.
Interventions
Spinal anesthesia with heavy bupivacaine of 6, 7, 8, 9, 10, 11 mg
Sponsors
Samsung Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients who are undergoing spinal anesthesia in Samsung Medical Center during study period * American Society of Anesthesiologist Physical Status classification I \ III
Exclusion criteria
* Bupivacaine allergy * medical history of spinal surgery * Diabetic neuropathy * active infection at the lumbosacral area * other contraindication of spinal anesthesia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| spinal anesthetic success/ failure | at 2 hour after the anesthetic induction | when (1) a bilateral T12 sensory block to pinprick within 15 minutes of intrathecal drug administration with sensory/motor block scale ≥ 2 and (2) the level of sensory block at the end of surgery was higher than or equal to T12 with sensory/motor block scale ≥ 2. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Peak level of sensory block at anesthesia induction | during 20 min after anesthetic induction | Sensory block levels determined by pinprick test |
| Spinal anesthesia sensory/motor block level at the end of surgery | 2 hours after induction (at the end of surgery) | Spinal anesthesia block level as determined by Pinprick sensory test with Bromage scale. Sensory 0 = an ability to appreciate a pinprick as sharp; 1 = perception of a pinprick as less sharp than in unblocked areas; 2 = perception of a pinprick as touch but not sharp (analgesia); 3 = an inability to feel pinprick(anesthesia). Bromage Scale 0 = ability to lift an extended knee at the hip; 1 = ability to flex the knee but not to lift an extended leg; 2 = ability to flex toes only; 3 = inability to move. |
| the incidence of tourniquet pain | at 90 min afer anesthetic induction | the incidence of tourniquet pain during the tourniquet time reported by the patient (NRS \>= 2) |
| Incidence of hypotension, bradycardia | during 2 hours after anesthesia induction | Incidence of hypotension, bradycardia total dose of ephedrine Lowest mean blood pressure Incidence of vomiting, shivering |
Countries
South Korea
Outcome results
None listed