Abstract
The role of the baricity of local anaesthetic solutions in determining the distribution of local anaesthetics injected into the subarachnoid space (and hence the level of anaesthesia) has been challenged. A recent study found no difference in the extent of cephalad spread of hyperbaric and isobaric solutions and concluded that density had no effect on the spread of local anesthetics. The present study, to determine the validity of this conclusion, utilized a spinal model filled with a “cerebrospinal fluid equivalent.” Following the injection of hyperbaric lidocaine, the local anaesthetic was most concentrated at the lower end of the column, whereas following the injection of isobaric solution the local anaesthetic was most concentrated around the site of injection. Therefore, baricity is an important determinant of local anaesthetic distribution in the subarachnoid space.
Résumé
On a recemment mis en doute l’influence de la baricilé sur la distribution (et le niveau anesthésique) des solutions d’anesthésique local injectées dans l’espace sousarachnoïdien. Ainsi, après avoir observé la même extension céphalade de l’effet de solutions hyperbare et isobare d’anesthésique, un auteur concluait à l’absence d’effet de la densité sur leur distribution. Avec notre étude, nous avons voulu vérifier cette conclusion en employant un modèle de canal rachidien rempli depseudo LCR. Nous avons pit mesurér qu’après l’injection de lidoca|:ine hyper bare, cette dernière se concentrait an fond du canal alors que la lidocaine isobare se distribuait de part el d’autre du site d’injection. La baricité joue done un rôle important dans la distribution des anesthesiques injectés dans l’espace sousarachno:idien.
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Lui, A.C.P., Munhall, R.J., Winnie, A.P. et al. Baricity and the distribution of lidocaine in a spinal canal model. Can J Anaesth 38, 522–526 (1991). https://doi.org/10.1007/BF03007593
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DOI: https://doi.org/10.1007/BF03007593