| Effect of Bevel Direction of 25G Spinal Needle and Addition of Epinephrine on Spinal Anesthesia. |
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Sang Chul Lee, Ji Yeon Sim, Sang Tae Kim |
1Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea.
2Department of Anesthesiology, College of Medicine, Ulsan University, Seoul, Korea. |
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| Abstract |
BACKGROUND
Distribution of local anesthetics injected into subarachnoid space is determined by many intrinsic & extrinsic factors. The purpose of this study was to compare the spread of spinal anesthetic agent according to the direction of bevel and addition of epinephrine.
METHOD
Eighty nine consenting patients, undergoing orthopedic surgery of lower extremities were divided into eight groups to direction of bevel and addition of epinephrine in each direction. In lateral decubitus position, 25-gauge spinal needle was introduced into the subarachnoid space and 1% tetracaine with the same volume of 10% dextrose was injected through the spinal needle.
Patients were turned to the supine position and checked sensory block level by pin-prick test at anterior axillary line every 5 minutes. Degree of motor block was measured by Bromage scale and two-segment regression time was measured by pin-prick test every 15 minutes interval after maximal sensory block level was reached.
RESULTS
No significant difference in maximum level of sensory block was found among groups. But two segment regression time was significantly prolonged in epinephrine added cephalad and down groups.
CONCLUSION
Direction of bevel did not affect maximum level of sensory block and duration of spinal anesthesia but, epinephrine prolonged the duration of local anesthetics in special directions. |
| Key Words:
Anesthetic techniques spinal; Anesthetics; local tetracaine; Direction of bevel; Sympathetic nervous system; pharmacology epinephrine |
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