Background: The aim of the study was to determine the median effective dose (ED50) for motor block of various concentrations of intrathecally administered plain bupivacaine.
Material And Methods: Between 2011 and 2013, 64 patients aged ≥70 years, undergoing transurethral, or lower limb surgery with combined spinal and epidural anesthesia in a single hospital were enrolled. The patients were randomized into 3 groups to receive intrathecal 0.75% bupivacaine (Group 1), 0.375% bupivacaine (Group 2) or 0.25% bupivacaine (Group 3). Spinal anesthesia was achieved using injections of up-and-down doses of 0.75%, 0.375%, or 0.25% plain bupivacaine. The first patient in each group received 7.5 mg bupivacaine, and the testing interval was set at 0.75 mg. The efficacy of motor block in both legs was determined using a modified Bromage and a hip motor function scale. The ED50 for motor block was estimated according to the Dixon's up-and-down method.
Results: The ED50 for motor block of bupivacaine was 6.10 (95% CI 5.58-6.66) mg in Group 1, 6.04 (95% CI 5.82-6.28) mg in Group 2, and 5.43 (95% CI 5.19-5.67) mg in Group 3. There were significant differences in the ED50 for motor block among the groups (P=0.008).
Conclusions: The ED50 doses for motor block with 3 bupivacaine concentrations were significantly different in elderly patients; the ED50 dose of 0.75% bupivacaine being significantly higher than that of 0.25% bupivacaine.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562610 | PMC |
| http://dx.doi.org/10.12659/MSM.894842 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Adenosine A2A receptor activation is necessary to gate the TrkB-dependent intramuscular nerve sprouting during muscle reinnervation after a nerve crush.
Heliyon
January 2025
Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy.
Compelling evidence has demonstrated that rehabilitation through physical exercise, a non-invasive and non-surgical intervention, enhances muscle reinnervation and motor recovery after peripheral nerve injury (PNI) by increasing muscle-derived brain-derived neurotrophic factor (BDNF) expression and triggering TrkB-dependent axonal plasticity. Adenosine has been widely acknowledged to trigger TrkB via A2A receptor (A2AR). Since motor nerve terminals co-express TrkBs and A2ARs and depolarizing conditions increase muscle release of BDNF and adenosine, we examined whether A2ARs activation could recapitulate the functional recovery benefits of intermittent exercise after a nerve crush.
View Article and Find Full Text PDFComparison of costoclavicular and lateral sagittal infraclavicular approaches in ultrasound-guided brachial plexus block.
Agri
January 2025
Department of Anesthesiology and Reanimation, Yozgat City Hospital, Yozgat, Türkiye.
Objectives: Lateral sagittal infraclavicular approach is frequently used because it has less risk of complications and provides rapid and adequate regional anesthesia. Due to the fact that the brachial plexus is deeper in the infraclavicular region and the approach angle is sharper, it can be technically challenging. In this study, we aimed to compare the costoclavicular approach, which is a newly defined approach, with the lateral sagittal infraclavicular brachial plexus block.
View Article and Find Full Text PDFEfficacy and Safety of Adding 1μg/Kg Dexmedetomidine to 20ml Bupivacaine in Supraclavicular Brachial Plexus Block: A Randomized Trial.
Curr Drug Saf
January 2025
Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Kafr-El Sheikh University, Kafr-El Sheikh, Egypt.
Background: For surgical procedures of the upper limbs, ultrasound-guided supraclavicular brachial plexus block (SCBPB) represents a safe substitute for general anesthesia. The present study evaluated the effectiveness and safety of incorporating 1μg/kg dexmedetomidine (DEX) into 20 ml bupivacaine, as opposed to using 20 ml and 30 ml bupivacaine without additives, in SCBPB.
Methods: This randomized, controlled, double-blind study included 75 patients assigned to elective upper-limb surgery under the mid-humerus level.
Retrospective Cohort Study on the Incidence and Management of Hemiplegic Shoulder Pain in Stroke Inpatients.
Cureus
December 2024
Physical Medicine and Rehabilitation, Centro de Reabilitação do Norte, Vila Nova de Gaia, PRT.
Background: Painful hemiplegic shoulder (PHS) is a prevalent and challenging complication following a stroke and can significantly impair a patient's engagement in rehabilitation, leading to poorer functional outcomes and extended hospital stays. This retrospective cohort study aims to investigate the incidence, etiology, and management of PHS in stroke inpatients, focusing on the effectiveness of various therapeutic interventions.
Methods: We conducted a retrospective analysis of subacute stroke inpatients who developed PHS during rehabilitation at a single center.
Failed Spinal Anesthesia: Incidence and Associated Factors.
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 PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!