Spinal Anesthetic Toxicity
Conditions
Keywords
levobupivacaine,spinal anesthesia ,temperature
Brief summary
This study will be conducted to evaluate the effect of different temperature on the spinal anesthesia characteristics and incidence of complications
Detailed description
Regional anesthesia techniques are also superior to systemic opioids agents with regard the analgesic profile and adverse effects .Spinal anesthesia is the most commonly used technique due to its unmatchable reliability,simplicity and cost-effectiveness. It provides a fast and effective onset of sensory and motor block, excellent muscle relaxation and prolonged postoperative analgesia . Bupivacaine is commonly used local anesthetics because of its long duration of action and combined motor and sensory blockade. However, it has many drawbacks .It has a high propensity to cause hypotension and bradycardia. There is also cardiac toxicity.Levobupivacaine is an attractive alternative to bupivacaine because of the lower affinity for cardiac sodium channels and reducing the risk of cardiac toxicity.Moreover ,the isobaric levobupivacaine had more stability in cerebrospinal fluid and thus lead to more predictable drug spread, decreasing the incidence of hypotension and bradycardia. But its main disadvantage is the delayed onset . A number of strategies have been used to hasten the onset of local anesthesia .The addition of fentanyl mixtures of local anesthetics and alkalization of the local anesthetics all shorten the onset time of sensory block. Recently the warming of the anesthetic agents (namely, lidocaine and bupivacaine) to 37° C hastens the sensory block in various surgical settings . Up till now there is no study suggestive of any appropriate degree of temperature as adjuvant .Hence the present study will be conducted to evaluate the effect of different temperature on spinal anesthesia characteristics and the incidence its complication
Interventions
Drug: levobupivacaine at room temperature ( 23˚C) and second group levobupivacaine warmed to the (30˚C) while the third group levobupivacaine warmed to the body temperature (37˚C)
Sponsors
Study design
Masking description
Double(participant ,care provider)
Eligibility
Inclusion criteria
* ASA-I or II
Exclusion criteria
* patient refusal; Any known hypersensitivity or contraindication to levobupivacaine pregnancy bleeding disorders local skin infections. Sepsis at the site of injection Coagulation abnormality Psychiatric disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to onset of sensory block | For 10 minutes following the spinal anesthesia | Defined as the time interval between the end of spinal anesthesia injection and the loss of sensation to pin prick (sensory score=1) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to the onset of motor block | For 10 minutes following the injection of spinal anesthesia | Defined as the time interval between the end of spinal anesthesia and (motor score=1) within both lower limbs |
| Duration of sensory block | For 24 hours after the spinal anesthesia | Defined as the interval between the end of spinal anesthesia and complete end of sensory block (sensory score=2) |
| Duration of motor block | For 24 hours after the spinal anesthesia | Defined as the interval between the end of spinal anesthesia and complete recovery of normal motor function (score=0) |
| Post spinal shivering | for 24 hours after spinal anesthesia | Post spinal shivering will be graded using a scale ( score 0=no shivering ,score 1= no visible muscle activity ,but one or more of piloerection, score 2=muscular activity in only one muscle group,score 3=moderate muscular activity in more than one muscle group but not generalized shaking ,score 4=violent muscular activity that involves entire body ) |
Countries
Egypt