Abstract

OYOLA, Gustavo et al. Estudio de los efectos de la dilución de anestésico local para técnica regional subaracnoidea en procedimientos quirúrgicos abdominales ambulatorios . Rev. colomb. anestesiol. [online]. 2007, vol.35, n.2, pp.129-134. ISSN 0120-3347.

Objectives: This study was designed to evaluate the hemodynamic differences and the adverse reactions of the levobupivacaine chlorhydrate 0,75% + fentanyl cytrate in normal saline 0,9% compared to the regional subarachnoid anesthesia standard technique. Methods: It was a prospective, randomized, multicentric , blinded and controlled study in which there were included 98 patients programmed for abdominal procedures. The studied variables were mean blood pressure, sensitive and motor blocking time, use of endovascular fluids during surgery, vasoactive drugs and time spent at the post - surgery recovery unit. Results: After we evaluated both groups, we found significant differences on the next variables: Reduction of mean blood pressure after one minute of the injection of the anaesthetic in the subaracnoid space in the treated group versus the control group. (71,96± 5,99 mm Hg CI: 1,69 Vs. 58,15 ± 3,70 mm Hg CI: 1,02); duration of the motor blockage (treatment group 18,04 ± 7,21 minutes CI: 2,03 Vs. control group 89,61±23,88 minutes CI: 6,6).Use of endovenous fluids (treatment group 78,39 ± 301,24 ml CI : 22,45 Vs. control group 2.115 ± 339 ml CI :94,07); time spent in the post - surgery recovery unit (treatment group 27,76±6,60 minutes CI :1,86 Vs control group 105,96 ± 30,07 minutes CI: 27,74); nausea (treatment group 7 patients 14,58% Vs. control group 21 patients 42%; vasoactive drug use (treatment group 0 patients (0%) Vs 34 patients in the control group 68%). There were not any significant differences in the sensitive blockage duration (treatment group 77±17,56 minutes CI :2,59 Vs. control group 74,80±18,24 minutes CI: 5,05) nor in the surgery time (treatment group 40,4±13,19 minutes CI: 3,73 Vs. control group 39,42 ± 8,76 minutes CI: 2,42). Conclusions : The dilution of the hyperbaric local anaesthetic for the regional subaracnoid anesthesia is safe and can be recommended as a standard technique in patients that are programmed for abdominal surgery lasting maximum 1 hour.

Keywords : subaracnoid anaesthesia; dilution; hyperbaric; sensitive level; motor level; local anaesthetics.

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