EPIDURAL ANESTHESIA BUPIVACAINE 0.5%+ KCL 5 MEQ/L VS BUPIVACAINE 0.5%
Abstract
Background. Although epidural anesthesia is a Successful method for most surgical procedures on lower extremities and lower abdomen. It is not so favorable because of it's slow onset and differential sensory and motor block. In order to solve this problem effects of additive KCl (5 meq/L) into Bupivacaine 0.5 percent according to onset, intensity, duration of block and homodynamic changes during epidural anesthesia will be investigated through the present study. Methods. All the ASA I or II patients at medical centers of Isfahan university of medical sciences throughout 1378, candidate for elective Surgical procedures on lower extremities and lower abdomen with no contraindication for epidural anesthesia were Subdivided into Case (35 patients) and Control (35 patients) groups in a random manner to perform a double blind clinical trial. Epidural anesthesia applied to cases (by Bupivacaine 0.5 percent+ KCl 5meq/L) and controls (by Bupivacaine 0.5 percent). Under identical conditions, data indicating basic MAP, basic heart rate and their changes as well as the onset, duration and intensity of motor and sensory block, were obtained and recorded by the anesthesiologist. Quantitative & qualitative variables were examined by T.test and X2 test respectively.
Findings. Sensory onset for cases (8.22±1.43Min) was faster than controls (11.56±1.45Min) (P<0.005). Motor onset for cases (12.77 ± 1.83Min) was faster than controls (20.24±1.71Min) (P < 0.005). Sensory duration for cases (l86.34±8.37 Min) was longer than controls (162.17±7.47Min) (P<0.005). Motor duration for cases (106.25±13.50 Min) was longer than controls (77.60 ± 9.94Min) (P < 0.005).Intensity of sensory block for cases was greater than controls (P < 0.01). Intensity of motor block for cases was greater than controls (P < 0.001). Mean heart rate changes for cases (7.28±9.37 percent) and controls (7 ± 8 percent) were not different (P < 0.8). Mean decrease in MAP for cases (20.17 ± 2.10n percent) was greater than controls (18.08±2.105 percent) (P < 0.01).
Conclusion. According to the results, it is understood that addition of KCl (5 meq/L) into bupivacaine 0.5 percent not only can improve the onset, intensity and duration of epidural anesthesia which modifies this technique to a more practical and fovorable one, but also avoids administration of high concentrations (?120 meq/L) of potassium and it's subsequent side effects which terminated further investigation as described by literature with no additional side effects.
Findings. Sensory onset for cases (8.22±1.43Min) was faster than controls (11.56±1.45Min) (P<0.005). Motor onset for cases (12.77 ± 1.83Min) was faster than controls (20.24±1.71Min) (P < 0.005). Sensory duration for cases (l86.34±8.37 Min) was longer than controls (162.17±7.47Min) (P<0.005). Motor duration for cases (106.25±13.50 Min) was longer than controls (77.60 ± 9.94Min) (P < 0.005).Intensity of sensory block for cases was greater than controls (P < 0.01). Intensity of motor block for cases was greater than controls (P < 0.001). Mean heart rate changes for cases (7.28±9.37 percent) and controls (7 ± 8 percent) were not different (P < 0.8). Mean decrease in MAP for cases (20.17 ± 2.10n percent) was greater than controls (18.08±2.105 percent) (P < 0.01).
Conclusion. According to the results, it is understood that addition of KCl (5 meq/L) into bupivacaine 0.5 percent not only can improve the onset, intensity and duration of epidural anesthesia which modifies this technique to a more practical and fovorable one, but also avoids administration of high concentrations (?120 meq/L) of potassium and it's subsequent side effects which terminated further investigation as described by literature with no additional side effects.
Keywords
Epidural Anesthesia, Bupivacaine, Potassium Chloride