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. 2011 Aug;43(2):103-8.
doi: 10.5152/eajm.2011.23.

Comparison of two different doses of intrathecal levobupivacaine for transurethral endoscopic surgery

Secil Dizman  1 , Gurkan Turker  1 , Alp Gurbet  1 , Elif Basagan Mogol  1 , Suat Turkcan  1 , Ziyaatin Karakuzu  1
Affiliations

Comparison of two different doses of intrathecal levobupivacaine for transurethral endoscopic surgery

Secil Dizman et al. Eurasian J Med. 2011 Aug.

Abstract
in English, Turkish

Objective: To evaluate the effects of two different spinal isobaric levobupivacaine doses on spinal anesthesia characteristics and to find the minimum effective dose for surgery in patients undergoing transurethral resection (TUR) surgery.

Materials and methods: Fifty male patients undergoing TUR surgery were included in the study and were randomized into two equal groups: Group LB10 (n=25): 10 mg 0.5% isobaric levobupivacaine (2 ml) and Group LB15 (n=25): 15 mg 0.75% isobaric levobupivacaine (2 ml). Spinal anesthesia was administered via a 25G Quincke spinal needle through the L3-4 intervertebral space. Sensorial block levels were evaluated using the 'pin-prick test', and motor block levels were evaluated using the 'Bromage scale'. The sensorial and motor block characteristics of patients during intraoperative and postoperative periods and recovery time from spinal anesthesia were evaluated.

Results: In three cases in the Group LB10, sensorial block did not reach the T10 level. Complete motor block (Bromage=3) did not occur in eight cases in the Group LB10 and in five cases in the Group LB15. The highest sensorial dermatomal level detected was higher in Group LB15. In Group LB15, sensorial block initial time and the time of complete motor block occurrence were significantly shorter than Group LB10. Hypotension was observed in one case in Group LB15. No significant difference between groups was detected in two segments of regression times: the time to S2 regression and complete sensorial block regression time. Complete motor block regression time was significantly longer in Group LB15 than in Group LB10 (p<0.01).

Conclusion: Our findings showed that the minimum effective spinal isobaric levobupivacaine dose was 10 mg for TUR surgery.

Amaç: Spinal anestezi özellikleri iki farklı spinal izobarik levobupivakain dozlarının etkilerini değerlendirmek ve transüretral rezeksiyon (TUR) ameliyatı geçiren hastalarda cerrahi için etkili en düşük dozu bulmak.

Gereç ve yöntem: TUR ameliyatı Elli erkek hasta çalışmaya alındı ve iki eşit gruba ayrıldı: Grup LB10 (n=25): 10mg %0.5 izobarik levobupivakain (2 ml) ve Grup LB15 (n=25): 15 mg %0.75 izobarik levobupivakain (2 ml). Spinal anestezi L3–4 intervertebral uzayda bir 25G Quincke spinal iğne ile uygulandı. Duyusal blok seviyeleri ‘pin-prick testi’ ile değerlendirildi ve motor blok seviyeleri ‘Bromage ölçeği’ ile değerlendirildi. Spinal anestezi ile intraoperatif ve postoperatif dönem ve iyileşme süresi boyunca hastaların duyusal ve motor blok özellikleri değerlendirildi.

Bulgular: Grup LB10 üç durumlarda, duyusal blok seviyesi T10 ulaşmadı. Komple motor blok (Bromage=3) Grup LB10 ve Grup LB15 beş olguda sekiz olguda görülmedi. Tespit edilen en yüksek duyusal dermatomal Düzeyli Grup LB15 daha yüksekti. Grup LB15 olarak, duyusal blok başlangıç zamanı ve tam motor blok oluşma süresi Grup LB10 anlamlı olarak kısa bulundu. Hipotansiyon Grup LB15 bir durum gözlenmiştir. S2 regresyon ve tam duyusal blok gerileme zaman zaman: Gruplar arasında anlamlı bir fark regresyon kez iki segment saptandı. Komple motor blok gerileme zamanı Grup LB10 (p<0.01) daha Grubu LB15 anlamlı olarak daha uzundu.

Sonuç: Bu bulgular en az etkili spinal izobarik levobupivakain doz TUR ameliyatı için 10 mg olduğunu gösterdi.

Keywords: Levobupivacaine; Spinal anesthesia; Transurethral surgery.

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Figures

Figure 1.
Figure 1.
Preoperative heart rate (HR) values (mean±SD). p>0.05 at all times.
Figure 2.
Figure 2.
Preoperative mean arterial pressure (MAP) (mean±SD). p>0.05 at all times.
Figure 3.
Figure 3.
Preoperative peripheral oxygen saturations (SpO2) (mean±SD). p>0.05 at all times.
Figure 4.
Figure 4.
Sensory block dermatomal level after spinal anesthesia (mean±SD). *p<0.05, statistical significance.
See this image and copyright information in PMC

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