BACKGROUND AND OBJECTIVES: Concerns of @entity1971 have discouraged clinicians to use 5% @entity3303 for continuous spinal anesthesia. Earlier reports indicated that single-shot spinal @entity3303 0.5% is effective for minor gynecologic and perianal surgery. In the present study, we evaluate the anesthetic and hemodynamic effects of low dose hyperbaric 0.5% @entity3303 for continuous spinal anesthesia and compare with those of the 5% @entity3303 solution in @entity1 undergoing urologic surgery. METHODS: Spinal anesthesia was induced via an indwelling subarachnoid catheter in 42 elderly male @entity1 (range, 57-84 years) undergoing transurethral prostate and bladder procedures. @entity1 were randomly assigned to receive an initial 30-mg bolus of hyperbaric @entity3303 in the form of either 6 mL of 0.5% solution or 0.6 mL of 5% solution. Additional 30-mg boluses (to a total of 90 mg) were given, if necessary, to establish initial sensory block to T10 or higher and lower limb @entity912 . Supplemental doses of 30 mg or less were given during surgery, as needed. Dermatomal level of sensory anesthesia and degree of motor blockade were assessed at regular intervals by a blinded observer. Heart rate and blood pressure (mean systolic and diastolic) values were monitored at regular intervals. RESULTS: Forty @entity1 were studied successfully. Both hyperbaric 0.5% and 5% @entity3303 provided adequate surgical anesthesia in 75% (30/40) of @entity1 after a single 30-mg dose. A median peak sensory level of T5 (range, T2-T9) achieved within 11.1 +/- 4.5 minutes in @entity1 receiving the 0.5% solution was significantly higher than the peak sensory level of T7 (range, T4-T12) in the 5% group (P = .043). The duration of surgical anesthesia after a 30-mg dose was similar in both groups--48.1 +/- 12.1 minutes versus 50.8 +/- 16.5 minutes respectively. Of the 30 @entity1 (15 in each group) who received 30 mg initially, 25 required repeat @entity3303 dosing through the catheter during surgery. The maximum decrease in heart rate and blood pressure values was within 10% and 20%, respectively, of baseline values in both groups. In the remaining @entity1 (10/40), anesthesia was achieved successfully in five @entity1 in the 0.5% group and three @entity1 in the 5% group after two 30-mg @entity3303 boluses (60 mg) and two @entity1 in the 5% group after three 30-mg boluses (90 mg). CONCLUSIONS: Continuous spinal anesthesia produced by 0.5% @entity3303 with 7.5% @entity413 is as effective as that produced by the 5% @entity3303 solution in elderly @entity1 undergoing urologic surgery. An initial 30-mg bolus delivered via indwelling subarachnoid catheter was sufficient to achieve surgical anesthesia for approximately 50 minutes in most @entity1 . Hemodynamic effects of the two @entity3303 solutions were also comparable.

A comparative study of low-dose hyperbaric spinal XXXX 0.5% versus 5% for continuous spinal anesthesia.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity912 :: ('MESH:D010243', 'Disease') :: ['paralysis'] @entity3303 :: ('MESH:D008012', 'Chemical') :: ['lidocaine'] @entity1971 :: ('MESH:D011128', 'Disease') :: ['cauda equina syndrome'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['dextrose']
@entity3303 :: (MESH:D008012,Chemical) :: ['lidocaine']
