Abstract
The aim of this study was to compare two equipotent solutions of hyperbaric bupivacaine and tetracaine in 30 elderly patients undergoing elective hip surgery under continuous spinal anaesthesia. With the patient in the supine position, 2 ml (8 mg) of either hyperbaric solution (density 1.030) were administered in a double-blind and randomized fashion. The median maximum sensory and temperature discrimination levels (T5 and T4) were similar with both solutions. The duration of analgesia was not different (114 ± 23 min for bupivacaine and 125 ± 35 min for tetracaine). Thirteen out of fifteen patients receiving bupivacaine and all 15 patients receiving tetracaine had complete motor blockade. The haemodynamic changes and vasopressor requirements were comparable. The plasma catecholamine levels measured at four different times remained unchanged and were not different between the two groups at any time. The authors conclude that, during continuous spinal anaesthesia, equipotent hyperbaric solutions of bupivacaine and tetracaine have similar anaesthetic and haemodynamic effects.
Résumé
Le but de cette étude était de comparer deux solutions équipotentes de tetracaine et de bupivacaine hyperbares, chez 30 patients agés devant subir une chirurgie de la hanche en rachianesthésie continue. Chaque patient, en position horizontal stride, a reçu en doubleaveugle et de façon randomisée 2 ml (8 mg) d’une de deux solutions (densité 1,030). Aucune différence n ’a été notée entre les deux groupes en ce qui concerne la valeur médiane des niveaux sensitifs et de discrimination thermique supérieurs (T5 et T4). La durée de l’analgésie (114 ± 23 min. pour la bupivacaine et 125 ± 35 min. pour la tetracaine) était semblable dans les deux groupes. Treize patients sur les 15 du groupe bupivacaine et tous les 15 patients du groupe tetracaine avaient un bloc moteur complet. Les modifications hémodynamiques ainsi que les besoins en vasopresseurs ont été comparables dans les deux groupes. Les taux de catécholamines plasmatiques, mesurés à quatre moments différents de l’étude, sont restés stables et semblables dans les deux groupes à chaque temps. Les auteurs concluent que lorsqu ’on compare la bupivacaine et la tetracaine hyperbares au cours d’une anesthésie spinale continue, les solutions equipotentes de ces deux drogues possedènt des effets anesthésiques et hémodynamiques similaires.
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Van Gessel, E.F., Miege, B., Forster, A. et al. Comparison of hyperbaric solutions of bupivacaine and tetracaine during continuous spinal anaesthesia. Can J Anaesth 39, 323–329 (1992). https://doi.org/10.1007/BF03009041
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DOI: https://doi.org/10.1007/BF03009041