Aim: To compare the effects of hyperbaric and isobaric bupivacaine spinal anesthesia on hemodynamics and heart rate variability (HRV) in nonobstetric surgery.
Materials And Methods: Sixty patients were randomly allocated to 2 groups. Group I (n = 30) received 15 mg (3 mL) of hyperbaric bupivacaine and Group II (n = 30) received 15 mg (3 mL) of isobaric bupivacaine for spinal anesthesia. Hemodynamic parameters were recorded before and after spinal anesthesia over 30 min. Analyses of HRV were performed on the day of surgery, after volume loading, and 20 min after spinal injection. Low frequency (LF) values, high frequency (HF) values, and LF/HF ratios were recorded. The incidences of hypotension and alterations of HRV parameters in both groups were investigated.
Results: The incidence ofhypotension was 26.6% and 23.3% in Groups I and II, respectively. There were no significant differences in the LF and HF values and LF/HF ratios between groups. In Group I, LF/HF ratios were significantly lower and HF values were significantly higher at 20 min after spinal anesthesia, in comparison to the baseline value (P < 0.05).
Conclusion: Hyperbaric bupivacaine caused a significantly greater decrease in LF/HF ratios and a significantly greater increase in HF values.
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http://dx.doi.org/10.3906/sag-1207-1 | DOI Listing |
Pain Pract
February 2025
Department of Anesthesia & Critical Care, University of Chicago, Chicago, Illinois, USA.
Purpose: To determine whether preoperative magnetic resonance imaging (MRI) can reliably determine intraoperative measurements in the Vertiflex Interspinous Spacer (ISS) procedure.
Methods: Patients who underwent Vertiflex ISS with Lumbar Spinal Stenosis (LSS) and a preoperative MRI available in picture archiving and communication system (PACS) between January 2013 to February 2023 were identified retrospectively from the University of Chicago Medical Center Database. An experienced board-certified pain specialist and well-trained 2nd-year medical student independently performed measurements of the interspinous space where Vertiflex ISSs of various sizes are inserted.
Cureus
December 2024
Department of Anaesthesiology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Introduction Spinal anesthesia, a commonly used technique for lower abdominal, pelvic, and lower extremity surgeries, involves injecting a local anesthetic into the subarachnoid space to temporarily block sensory, motor, and sympathetic nerves. Despite its high success rate, the failure of spinal anesthesia, which can lead to adverse patient outcomes, remains a concern. The failure rate varies widely, from 1% to 17%, influenced by factors such as technical challenges, patient anatomy, and practitioner experience.
View Article and Find Full Text PDFCureus
December 2024
Community Medicine, Autonomous State Medical College, Auraiya, IND.
Introduction: Laparoscopic cholecystectomy has evolved into a daycare procedure thanks to advancements in both surgical and anesthetic techniques. Regional anesthesia, specifically segmental thoracic spinal anesthesia (TSA), offers distinct benefits over general anesthesia, such as enhanced hemodynamic stability and quicker recovery, especially in high-risk patients. This study aims to compare the sensory and motor block characteristics, hemodynamic stability, and incidence of adverse effects between isobaric and hyperbaric 0.
View Article and Find Full Text PDFSurg Infect (Larchmt)
January 2025
Department of Nursing, Affiliated Hospital of Guizhou Medical University, Guiyang, China.
The risk of poor surgical site healing in patients with spinal tuberculosis due to infection is known to be higher than in other surgical patients. Early identification and diagnosis are critical if we are to reduce the disability and mortality associated with spinal tuberculosis. We aimed to develop and validate a novel predictive score for predicting the risk of poor surgical site healing in patients following surgical procedure for spinal tuberculosis.
View Article and Find Full Text PDFPerioper Med (Lond)
January 2025
Department of Anesthesiology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Objective: This study aims to explore the analgesic effects and safety of periarticular injections of methylene blue (MB) combined with a cocktail formulation following total knee arthroplasty (TKA).
Methods: A total of 70 patients undergoing total knee arthroplasty were selected and divided into two groups based on the cocktail formula used for periarticular infiltration, including the methylene blue group (M group, n = 35) and the control group (C group, n = 35). Both groups underwent spinal anesthesia.
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