A low-dose XXXX : a comparison of hyperbaric and hypobaric solutions for unilateral spinal anesthesia.

@entity1 @entity1341 @entity6357
BACKGROUND AND OBJECTIVES: The injection of small doses of local anesthetic solutions through pencil-point directional needles and maintaining the lateral decubitus position for 15 to 30 minutes after the injection have been suggested to facilitate the unilateral distribution of spinal anesthesia. We evaluated the effects of hypobaric and hyperbaric @entity1341 in attempting to achieve unilateral spinal anesthesia for @entity1 undergoing lower limb orthopedic surgery. METHODS: Fifty @entity1 were randomly allocated into 2 groups to receive either 1.5 mL hyperbaric @entity1341 0.5% (7.5 mg; n = 25) or 4.2 mL hypobaric @entity1341 0.18% (7.5 mg; n = 25). Drugs were administered at the @entity6357 interspace with the @entity1 in the lateral position. @entity1 remained in this position for 15 minutes before turning supine for the operation. Spinal block was assessed by pinprick and modified Bromage scale on both sides. RESULTS: Unilateral spinal block was observed in 20 @entity1 in the hyperbaric group (80%) and in 19 @entity1 in the hypobaric group (76%) while in the lateral position. However, 15 minutes after @entity1 were turned supine, unilateral spinal anesthesia decreased to 68% of cases in the hyperbaric group and 24% of cases in the hypobaric group (P <.05). The motor block was more intense during the first 5 and 10 minutes (P <.05), but at the end of operation there was no difference between the groups. The hemodynamic changes were similar between the groups. CONCLUSION: As a result, unilateral spinal anesthesia with hyperbaric and hypobaric @entity1341 provided a rapid motor and sensory recovery and good hemodynamic stability, but more unilateral spinal block was achieved in @entity1 in the hyperbaric group when compared with @entity1 in the hypobaric group.
