Key result
Increasing 0.5% hyperbaric bupivacaine volumes produces faster onset, higher levels, and longer sensory and motor blockade.
Why the study?
The optimal volume of 0.5% hyperbaric bupivacaine for subarachnoid block to achieve desired sensory and motor blockade levels and duration was unclear.
Does increasing the volume of 0.5% hyperbaric bupivacaine alter the onset, level, and duration of sensory and motor blockade in patients undergoing lower body surgeries under spinal anesthesia?
RCT (n=90)
envelope method
Does increasing the volume of 0.5% hyperbaric bupivacaine alter the onset, level, and duration of sensory and motor blockade in patients undergoing lower body surgeries under spinal anesthesia?
Doses of 0.5% hyperbaric bupivacaine can be titrated to achieve desired sensory and motor blockade, with lower volumes offering better cardiovascular stability.
Supports titrating hyperbaric bupivacaine volume for targeted blockade and hemodynamic stability in lower-body surgery; extends RCT dose-response data.
AIMS AND OBJECTIVES aim of the study is: 1. To observe the onset time of sensory and motor blockade. 2. To compare levels and duration of sensory and motor blockade. 3. And to observe associated complications in subarachnoid block using 2.5 mL, 3 mL and 3.5 mL of 0.5% bupivacaine (hyperbaric). AND METHODS prospective randomised clinical study was carried out on 90 patients belonging to ASA grade I and II, posted for elective , lower abdominal and lower extremities surgeries, under spinal anaesthesia. 90 patients were randomly divided into three groups using envelope method with 30 patients in each group. 1. Group A: Patients received 2.5 mL of hyperbaric solution of 0.5% bupivacaine. 2. Group B: Patients received 3.0 mL of hyperbaric solution of 0.5% bupivacaine. 3. Group C: Patients received 3.5 mL of hyperbaric solution of 0.5% bupivacaine. after the injection, the patient was positioned in the supine horizontal position and the following parameters evaluated. Time of onset of sensory blockade, Maximum level of sensory blockade, Duration of sensory blockade, Time onset of motor blockade, Maximum level of Motor blockade, Duration of motor blockade. onset of sensory and motor blockade was faster with the increasing volumes of the drug. Higher levels of sensory were achieved with the increasing drug volumes. The duration of sensory and motor blockade increased with the volumes of drug. The duration of motor block was directly proportional to the volume of the drug injected. conclude from our study that the doses of 0.5% hyperbaric bupivacaine can be titrated according to the level and duration sensory and motor blockade desired using minimum amount of drug necessary. The cardiovascular stability was better at volumes of the drug.
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Hina et al. (2016) conducted an RCT in elective urogenital, lower abdominal and lower extremities surgeries (n=90). 0.5% bupivacaine (hyperbaric) vs. Different volumes compared against each other was evaluated on Onset time, maximum level, and duration of sensory and motor blockade. Increasing volumes of 0.5% hyperbaric bupivacaine (2.5 mL, 3.0 mL, and 3.5 mL) produced faster onset, higher levels, and longer duration of sensory and motor blockade.
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