Abstract
We investigated the spread of spinal anesthesia with hyperbaric dibucaine in 20 adolescents aged 9–18 yr and 20 adults aged 23–53 yr. No significant difference was found between the two groups with regard to height, whereas a statistical significant was found between the two groups with regard to weight. Spinal anesthesia was conducted with Neo-Percamin S® injected at the L3–L4 interspace through a 25-gauge spinal needle. Injected volumes of the anesthetic solution were calculated from the patients’ height at 0.01 ml·cm−1. In adolescents, 1.6±0.1 ml (mean±SD) of the anesthetic solution produced 19.4 ±1.5 spinal segments blocked. In adults, 1.6±0.1 ml of the solution produced 13.4±1.6 spinal segments blocked. A high spinal anesthesia above T5 was achieved in 11 (85%) patients in adolescents, whereas such a high level of spinal anesthesia was not experienced in adults. These results suggest that the hyperbaric dibucaine solution for spinal anesthesia in adolescents may have a tendency to produce an unexpectedly extensive spread of anesthesia.
Similar content being viewed by others
References
Greene NM: Distribution of local anesthetic solutions within the subarachnoid space. Anesth Analg 64:115–130, 1985
Berkowitz S, Greene BA: Spinal anesthesia in children: Report based on 350 patients under 13 years of age. Anesthesiology 12:316–381, 1951
Melman E, Penuelas JA, Marrufo JE: Regional anesthesia in children. Anesth Analg 54:381–390, 1915
Dohi S, Naito H, Takahashi T: Age-related changes in blood pressure and duration of motor block in spinal anesthesia. Anesthesiology 50:319–323, 1919
Abajian JC, Mellish RWP, Browne AF, et al: Spinal anesthesia for surgery in the high-risk infant. Anesth Analg 63:359–362, 1984
Harnik EV, Hoy GR, Potolicchio S, et al: Spinal anesthesia in premature infants recovering from respiratory distress syndrome. Anesthesiology 64:95–99, 1986
Nightingale PJ: Barbotage and spinal anaesthesia. The effect of barbotage on spread of analgesia during isobaric spinal anaesthesia. Anaesthesia 38:79, 1983
Cameron AE, Arnord RW, Ghoris MW, et al: Spinal analgesia using bupivacaine 0.5% plain. Variation in the extent of the block with patient age. Anaesthesia 36:318–322, 1981
Pitkänen M, Haapaniemi L, Tuominen M, et al: Influence of age on spinal anaesthesia with isobaric 0.5% bupivacaine. Br J Anaesth 56:279–284, 1984
Bengtsson M, Edström HH, Lofstrom JB: Spinal analgesia with bupivacaine, mepivacaine and tetracaine. Acta Anaesthesiol Scand 27:278–283, 1983
Tuominen M, Pitkänen M, Doepel M, et al: Spinal anaesthesia with hyperbaric tetracaine: effect of age and body mass. Acta Anaesthesiol Scand 31:474–478, 1987
Veering BT, Burm AGL, Spierdijk J: Spinal anaesthesia with hyperbaric bupivacaine. Effects of age on neural blockade and pharmacokinetics. Br J Anaesth 60:187–194, 1988
Racle Jp, Benkhdra A, Poy JY, et al: Spinal analgesia with hyperbaric bupivacaine: influence of age. Br J Anaesth 60:508–514, 1988
Dripps RD, Eckenhoff JE, Vandam LD: Introduction to Anesthesia, The principle of safe practice. 6th ed. Philadelphia, WB Saunders, 1982, pp. 216–228
Stoelting RK, Miller RD: Basics of anesthesia. New York, Churcill Livingstone, 1984, pp. 167–181
Yasoshima S: Accidental death associated to anesthesia — from the view of legal medicine. (in Japanese) Rinsho Masui, Journal of Clinical Anesthesia 10:1288–1296, 1986
Caplan RA, Ward RJ, Posner K, et al: Unexpected cardiac arrest during spinal anesthesia. A closed claims analysis of prediposing factors. Anesthesiology 68:5–11, 1988
Murphy TM: Spinal, epidural, and caudal anesthesia. Anesthesia (2nd ed.), Edited by Miller RD, New York, Churchill Livingstone, 1986, pp. 1061–1111
Vaughan VC III: Growth and development. Nelson textbook of pediatrics. (12th ed.), Edited by Behrman RE and Vaughan VC III. Philadelphia, WB Saunders, 1983, pp. 10–38
Author information
Authors and Affiliations
About this article
Cite this article
Hirabayashi, Y., Shimizu, R. The intrathecal spread of hyperbaric dibucaine in adolescents. J Anesth 7, 167–172 (1993). https://doi.org/10.1007/s0054030070167
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s0054030070167