Effect of Injection Speed on the Anesthetic Level and Duration of Hypobaric Spinal Anesthesia with 0.1% Tetracaine in Jack-Knife Position at 15o Head-down Tilting.

Kim,  Jung Lyul; Kim,  Gab Soo; Shim,  Yon Hee; Shin,  Yang Sik

doi:1998.35.6.1100

Clinical Research Article

Korean Journal of Anesthesiology 1998;35(6):1100-1104.
DOI: https://doi.org/10.4097/kjae.1998.35.6.1100

Effect of Injection Speed on the Anesthetic Level and Duration of Hypobaric Spinal Anesthesia with 0.1% Tetracaine in Jack-Knife Position at 15o Head-down Tilting.

Jung Lyul Kim, Gab Soo Kim, Yon Hee Shim, Yang Sik Shin

Department of Anesthesiology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND
The speed of injection of local anesthetic solutions into the subarachnoid space may influence the spread of these agents in the cerebrospinal fluid by the amount of turbulence generated, especially with large volume. To determine the proper injection speed of anesthetics in hypobaric spinal anesthesia on jack-knife position, the anesthetic level and duration were measured with the fast or slow injection speed.
METHODS
Twenty patients for perianal surgery in jack-knife position under hypobaric spinal anesthesia were randomly assigned to one of two groups. Tetracaine (0.1%) in distilled water 5 ml was administered to all the patients. Group I patients received the drug with the speed of injection as 5 ml/20 sec (15 ml/min) and the others (Group II) as 5 ml/4 min (1.25 ml/min). The mean arterial pressures and heart rates at the preanesthetic period, and 5, 10, 15 and 20 min after the end of injection were measured. The anesthetic levels at 5, 10, 15 and 20 min after the injection and anesthesia duration were measured.
RESULTS
There was no significant difference in mean arterial pressures, heart rates and anesthetic duration between two groups. The anesthetic level 20 min after the injection was higher in Group I than Group II, and not different at the other time sequences.
CONCLUSION
At the injection speed within 1.25-15 ml/min in hypobaric spinal anesthesia on jack-knife position at 15o head-down, we acquired appropriate anesthetic level and duration for perianal surgery without any undesirable effects.

Key Words: Anesthesia, duration; Anesthetic techniques, spinal, injection speed; Anesthetics, local, tetracaine, hypobaric; Position, jack-knife, prone