Spinal Anesthetic Toxicity Clinical Trial
Official title:
The Influence of Different Degrees of Levobupivacaine Temperature on Spinal Anesthesia in Orthopedic Surgeries: Prospective Randomized Study
This study will be conducted to evaluate the effect of different temperature on the spinal anesthesia characteristics and incidence of complications
Regional anesthesia techniques are also superior to systemic opioids agents with regard the
analgesic profile and adverse effects .Spinal anesthesia is the most commonly used technique
due to its unmatchable reliability,simplicity and cost-effectiveness. It provides a fast and
effective onset of sensory and motor block, excellent muscle relaxation and prolonged
postoperative analgesia .
Bupivacaine is commonly used local anesthetics because of its long duration of action and
combined motor and sensory blockade. However, it has many drawbacks .It has a high propensity
to cause hypotension and bradycardia. There is also cardiac toxicity.Levobupivacaine is an
attractive alternative to bupivacaine because of the lower affinity for cardiac sodium
channels and reducing the risk of cardiac toxicity.Moreover ,the isobaric levobupivacaine had
more stability in cerebrospinal fluid and thus lead to more predictable drug spread,
decreasing the incidence of hypotension and bradycardia. But its main disadvantage is the
delayed onset .
A number of strategies have been used to hasten the onset of local anesthesia .The addition
of fentanyl mixtures of local anesthetics and alkalization of the local anesthetics all
shorten the onset time of sensory block. Recently the warming of the anesthetic agents
(namely, lidocaine and bupivacaine) to 37° C hastens the sensory block in various surgical
settings .
Up till now there is no study suggestive of any appropriate degree of temperature as adjuvant
.Hence the present study will be conducted to evaluate the effect of different temperature on
spinal anesthesia characteristics and the incidence its complication
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