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document
[ Bupivacaine-CO2 and bupivacaine-HCl at various injection temperatures in peridural anesthesia for extracorporeal shock wave lithotripsy ] . INTRODUCTION The effect of different injection temperatures on carbonated anesthetics has been controversial since 1965 . The current study was undertaken to determine onset times of sensory and motor blockade after epidural anesthesia with 0.5 % bupivacaine-CO2 and 0.5 % bupivacaine-HCl at various injection temperatures . MATERIALS AND METHODS The study was performed on 90 ASA class I-II urologic patients during extracorporeal shock wave lithotripsy . The patients were randomized in six groups to receive either 0.5 % bupivacaine-CO2 or 0.5 % bupivacaine-HCl at temperatures of 4 degrees , 20 degrees , or 36 degrees C. The six groups were comparable in age , height , and weight . Epidural anesthesia was performed at the L2-3 interspace with an 18-gauge Tuohy needle using loss of resistance . A catheter was advanced 4 cm in the epidural space and 4 ml 0.5 % bupivacaine with adrenaline 1:200,000 was given as a test dose . After 4 min the full anesthetic dose , based on body size , was injected with the patient supine . Sensory blockade was determined by the pinprick method and motor blockade by the Bromage method at 2-min intervals for the first 20 min , at 5-min intervals for the next 10 min , and then every 15 min to a total of 240 min . Statistical analysis was done by the Mann-Whitney test , with P less than 0.05 considered significant . RESULTS Spread of sensory blockade was significantly faster with bupivacaine-CO2 and -HCl at a temperature of 36 degrees C as compared to 4 degrees or 20 degrees C ( P less than 0.05 ) ( Figs . 1 , 2 and Table 2 ) . ( ABSTRACT TRUNCATED AT 250 WORDS )
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Intervention_Pharmacological
Bupivacaine-CO2
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Intervention_Pharmacological
bupivacaine-HCl
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Intervention_Pharmacological
peridural anesthesia
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Intervention_Pharmacological
epidural anesthesia
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Intervention_Pharmacological
bupivacaine-CO2
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Intervention_Pharmacological
bupivacaine-HCl
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Intervention_Physical
extracorporeal shock wave lithotripsy .
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Intervention_Pharmacological
bupivacaine-CO2
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Intervention_Pharmacological
bupivacaine-HCl
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Intervention_Pharmacological
Epidural anesthesia
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Intervention_Physical
18-gauge Tuohy
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Intervention_Pharmacological
bupivacaine with adrenaline
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Intervention_Pharmacological
bupivacaine-CO2
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Intervention_Pharmacological
-HCl
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Outcome_Other
onset times of sensory and motor blockade
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Outcome_Other
Sensory blockade
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Outcome_Other
motor blockade
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Outcome_Other
Spread of sensory blockade
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Participant_Sample-size
90
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Participant_Condition
ASA class I-II urologic