Evaluation of the Distribution of Topical Bupivacaine in Epidural anesthesia with MRI

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Resident, Department of Anesthesiology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assosciate Professor, Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Epidural anesthesia is one of the most common anesthesia methods, in surgical procedures. Since there is not any exact information about the spread of local anesthetic substances in epidural area, in this study we evaluated the distribution of Bupivacaine in epidural anesthesia.Methods: After giving necessary information and signing the permission form, 24 patient candidates for elective cholecystectomy were enrolled in the study. They were selected by simple probable method. Before the surgery in sitting position by aseptic technique 8 CC bupivacaine plus 1 CC magnevist (as contrast) injected to the epidural space. Then patient transferred to the MRI room and images prepared by MRI studied by the radiologist. Heart rate, systolic and diastolic blood pressure and mean arterial pressure were measured at the injection time and 5 and 10 minute later.Findings: Among 24 patients (15 women and 9 men) we recognized that the mean distribution of applied medications in men and women were 4.8 and 5.5 level respectivly (P < 0.05). There was not any relationship between local anesthetic distribution with age and weight. Height and body mass index had a significant convert correlation with the distribution of bupivacaine. Heart rate, systolic and diastolic blood pressure and mean arterial pressure were significantly decreased in studied times.  Conclusion: We found that the distribution of bupivacaine among men are less than women. The distribution of bupivacaine in cephalad direction was more than codal direction.

Keywords

References

  1. Miller RD. Miller's anesthesia. In: Cray RS, Chales BB, Editors. Anesthesia for obstetrics .Philadelphia: Elsevier; 2010. p. 2224.
  2. Djurhuus H, Rasmussen M, Jensen EH. Epidural blood patch illustrated by CT-epidurography. Acta Anaesthesiol Scand 1995; 39(5): 613-7.
  3. Philip JH, Brown WU. Total spinal anesthesia late in the course of obstetric bupivacaine epidural block. Anesthesiology 1976; 44(4): 340-1.
  4. Gaiser R. Postdural puncture headache. Curr Opin Anaesthesiol 2006; 19(3): 249-53.
  5. Zarzur E. Anatomic studies of the human ligamentum flavum. Anesth Analg 1984; 63(5): 499-502.
  6. Eisenach JC. Combined spinal-epidural analgesia in obstetrics. Anesthesiology 1999; 91(1): 299-302.
  7. Bernards CM. Sophistry in medicine: lessons from the epidural space. Reg Anesth Pain Med 2005; 30(1): 56-66.
  8. Szeinfeld M, Ihmeidan IH, Moser MM, Machado R, Klose KJ, Serafini AN. Epidural blood patch: evaluation of the volume and spread of blood injected into the epidural space. Anesthesiology 1986; 64(6): 820-2.
  9. Clyburn P. Epidural Anesthesia for cesarean section. Head ache Anesth Analg 2004; 90: 1389-404.
  10. Koren G, Pastusak A, Ito S. Drugs in pregnancy (review). N Engl J Med 1998; 338: 1128-37.
  11. Coombs DW, Dennis W, Hooper D. Subarachnoid Pressure with Epidural Blood "Patch". Regional Anesthesia & Pain Medicine 1979; 4(3): 3-6.
  12. Hogan QH. Lumbar epidural anatomy. A new look by cryomicrotome section. Anesthesiology 1991; 75(5): 767-75.
Journal of Isfahan Medical School
Volume 29, Issue 154 - Serial Number 154
July and August 2011
Pages 1334-1340

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History

  • Receive Date: 15 July 2011
  • Revise Date: 24 May 2024
  • Accept Date: 06 April 2022

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