Hostname: page-component-8448b6f56d-jr42d Total loading time: 0 Render date: 2024-04-18T07:39:06.346Z Has data issue: false hasContentIssue false
  • English
  • Français

Anaesthetic and haemodynamic effects of continuous spinal versus continuous epidural anaesthesia with prilocaine

Published online by Cambridge University Press:  02 June 2005

R. Reisli ,
J. Celik ,
S. Tuncer ,
A. Yosunkaya  and
S. Otelcioglu
R. Reisli
Affiliation:
University of Selcuk, Faculty of Medicine, Department of Anaesthesiology, Konya, Turkey
J. Celik
Affiliation:
University of Selcuk, Faculty of Medicine, Department of Anaesthesiology, Konya, Turkey
S. Tuncer
Affiliation:
University of Selcuk, Faculty of Medicine, Department of Anaesthesiology, Konya, Turkey
A. Yosunkaya
Affiliation:
University of Selcuk, Faculty of Medicine, Department of Anaesthesiology, Konya, Turkey
S. Otelcioglu
Affiliation:
University of Selcuk, Faculty of Medicine, Department of Anaesthesiology, Konya, Turkey
Get access

Extract

Summary

Background and objective: To compare, using prilocaine, the effects of continuous spinal anaesthesia (CSA) and continuous epidural anaesthesia (CEA) on haemodynamic stability as well as the quality of anaesthesia and recovery in patients undergoing transurethral resection of the prostate gland.

Methods: Thirty patients (>60 yr) were randomized into two groups. Prilocaine, 2% 40 mg, was given to patients in the CSA group, and prilocaine 1% 150 mg was given to patients in the CEA group. Incremental doses were given if the level of sensory block was lower than T10 or if needed during surgery.

Results: There was a significant decrease in mean arterial pressure in Group CEA compared with Group CSA (P < 0.01). The decrease in heart rate in Group CSA occurred 10 min after the first local anaesthetic administration and continued through the operation (P < 0.05). The level of sensory anaesthesia was similar in both groups. The times to reach the level of T10 and the upper level of sensory blockade (Tmax) were 18.0 ± 4.7 and 25.3 ± 7.0 min in Groups CSA and CEA, respectively, and were significantly longer in Group CEA. The duration of anaesthesia was 76.8 ± 4 min and was shorter in Group CSA (P < 0.01).

Conclusions: Spinal or epidural anaesthesia administered continuously was reliable in elderly patients undergoing transurethral resection of the prostate. Continuous spinal anaesthesia had a more rapid onset of action, produced more effective sensory and motor blockade and had a shorter recovery period. Prilocaine appeared to be a safe local anaesthetic for use with either continuous spinal anaesthesia or continuous epidural anaesthesia.

Keywords

ANAESTHESIA, CONDUCTION, anaesthesia epiduralANAESTHESIA CONDUCTION, anaesthesia spinalANAESTHETICS, LOCAL, prilocaineAGE GROUPS, adult, aged
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 1 , January 2003 , pp. 26 - 30
Copyright
© 2003 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hole A, Terjesen T, Breivig H. Epidural versus general anaesthesia for total hip arthroplasty in elderly patients. Acta Anaesthesiol Scand 1980; 24: 279–287.Google Scholar
Rubin AP. Spinal anaesthesia. In: Wildsmith JA, ed. Principles and Practice of Regional Anaesthesia. London, UK: Churchill Livingstone, 1998: 70–80.
Reisli R, Horasanli E, Demirbilek S, et al. Anaesthetic and haemodynamic effects of single shot versus incremental titration of spinal prilocaine. Br J Anaesth 1999; 82: A380.Google Scholar
Schnider TW, Mueller-Duysing S, Johr M, Gerber H. Incremental dosing versus single-dose spinal anesthesia and hemodynamic stability. Anesth Analg 1993; 77: 1174–1178.Google Scholar
Favarel-Garrigues JF, Sztark F, Petitjean ME, Thicoipe M, Lassie P, Dabadie P. Hemodynamic effects of spinal anesthesia in elderly: single dose versus titration through a catheter. Anesth Analg 1996; 82: 312–316.Google Scholar
Klimscha W, Weinstabl C, Ilias W, et al. Continuous spinal anesthesia with a microcatheter and low-dose bupivacaine decreases the hemodynamic effects of centroneuraxis blocks in elderly patients. Anesth Analg 1993; 77: 275–280.Google Scholar
Sutter PA, Gamulin Z, Forster A. Comparison of continuous spinal and continuous epidural anaesthesia for lower limb surgery in elderly patients. A retrospective study. Anaesthesia 1989; 44: 47–50.Google Scholar
Kashanipour A, Strasser K, Klimscha W, et al. Continuous spinal anesthesia versus epidural anesthesia in surgery of the lower extremities. A prospective randomised study. Reg Anesth 1991; 14: 83–87.Google Scholar
Collard CD, Eappen S, Lynch EP, Concepcion M. Continuous spinal anesthesia with invasive hemodynamic monitoring for surgical repair of the hip in two patients with severe aortic stenosis. Anesth Analg 1995; 81: 195–198.Google Scholar
Grace D, Orr DA. Continuous spinal anaesthesia in acute respiratory failure. Anaesthesia 1993; 48: 226–228.Google Scholar
Bowdle TA, Freund PR, Slatley JT. Age-dependent lidocaine pharmacokinetics during lumbar peridural anesthesia with lidocaine hydrochloride. Reg Anesth 1986; 11: 123–127.Google Scholar
Baxter AD. Continuous spinal anesthesia: the Canadian perspective. Reg Anesth 1993; 18: 414–418.Google Scholar
Stanley D, Erskine R. A comparison of spinal and epidural anesthesia for hip arthroplasty. Can J Anaesth 1992; 39: 551–554.Google Scholar
Kestin IG, Madden AP, Mulvein JT, Goodman NW. Comparison of incremental spinal anaesthesia using a 32-gauge catheter with extradural anaesthesia for elective caesarean section. Br J Anaesth 1991; 66: 232–236.Google Scholar
Peterson DO, Borup JL, Chestnut JS. Continuous spinal anesthesia case review and discussion. Reg Anesth 1983; 8: 109–113.Google Scholar
Denny N, Masters R, Pearson D, et al. Postural puncture headache after continuous spinal anesthesia. Anesth Analg 1987; 66: 791–794.Google Scholar
Standl T, Beck H. Radiological examination of the intrathecal position of microcatheters in continuous spinal anaesthesia. Br J Anaesth 1993; 71: 803–806.Google Scholar
Standl T, Eckert S, Rundshagen I, Schulte am Esch J. A directional needle improves effectiveness and reduces complication of microcatheter continuous spinal anaesthesia. Can J Anaesth 1995; 42: 701–705.Google Scholar
Denny NM, Selander DE. Continuous spinal anaesthesia. Br J Anaesth 1998; 81: 590–597.Google Scholar
Horlocker TT, McGregor DG, Matsushige DK, et al. Neurologic complications of 603 consecutive continuous spinal anesthesia using macrocatheter and microcatheter techniques. Perioperative outcomes group. Anesth Analg 1997; 84: 1063–1070.Google Scholar
Mark JB, Steele SM. Cardiovascular effects of spinal anesthesia. Int Anesthesiol Clin 1989; 27: 31–39.Google Scholar
Malmqvist LA, Bengtsson M, Bjornsson G, Jorfeldt L, Lofstrom JB. Sympathetic activity and haemodynamic variables during spinal analgesia in man. Acta Anaesthesiol Scand 1987; 31: 467–473.Google Scholar
Defalque RJ. Compared effects of spinal and epidural anesthesia upon blood pressure. Anesthesiology 1962; 23: 627–630.Google Scholar
Masayuki M, Hajime S, Akiyosi N. The effect of lithotomy position on arterial blood pressure after spinal anesthesia. Anesth Analg 1995; 82: 96–98.Google Scholar
Bigler D, Hjortso NC, Edstrom H, Christensen NJ, Kehlet H. Comparative effects of intrathecal bupivacaine and tetracaine on analgesia, cardiovascular function and plasma catecholamines. Acta Anaesthesiol Scand 1986; 30: 199–203.Google Scholar
Logan MR, McClure IH, Wildsmith AW. Plain bupivacaine: unpredictable spinal agent. Br J Anaesth 1986; 58: 292–296.Google Scholar
Petros AJ, Barnard M, Smith D, Ronzoni G, Carli F. Continuous spinal anesthesia: dose requirements and characteristics of the block. Reg Anesth 1993; 18: 52–54.Google Scholar