ABSTRACT
OBJECTIVE: To study the relation between cerebrospinal fluid (CSF) glucose levels, the highest level of sensory block, and the duration of motor block after intrathecal injection of 2 mL of hyperbaric bupivacaine. To determine CSF glucose levels upon recovery from motor block. PATIENTS AND METHODS: A prospective study of 34 patients administered a spinal anesthetic in continuous infusion through a 22-gauge catheter. CSF samples were extracted through the catheter 5, 10, 15, 20, 30, 45, and 60 minutes after start of infusion and upon motor recovery. After each extraction the intensity of the motor block was assessed; the intensity of the sensory block was assessed after each extraction up to 20 minutes. RESULTS: Glucose concentrations in CSF tended to decrease from 5 minutes (1027.07 [SD 349.04] mg dL(-1)) until full motor recovery (247.50 [20.39] mg dL(-1)). The probability of finding a motor block at a CSF glucose concentration of 287.5 mg dL(-1) or higher was less than 5%. We identified a positive correlation between the highest level of sensory block and the duration of full motor block (r=0.62, P<0.01) and between CSF glucose levels at the moment of greatest sensory block and upon full motor recovery (r=0.50, P<0.01). CONCLUSIONS: After continuous spinal anesthesia with hyperbaric bupivacaine, glucose concentrations in CSF are directly related to the highest level of sensory block, the course of the blockade, and its reversal.
Subject(s)
Anesthesia, Spinal , Anesthetics, Local/pharmacokinetics , Bupivacaine/pharmacokinetics , Glucose Solution, Hypertonic/pharmacokinetics , Glucose/cerebrospinal fluid , Movement/drug effects , Sensation/drug effects , Aged , Anesthesia Recovery Period , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Drug Interactions , Female , Glucose Solution, Hypertonic/administration & dosage , Humans , Hydrogen Bonding , Injections, Spinal/methods , Male , Prospective Studies , SolubilityABSTRACT
OBJETIVO: Estudiar la relación de la glucorraquia conel nivel más alto del bloqueo sensitivo y con la duracióndel bloqueo motor después de la administración intratecalde 2 mL de bupivacaína hiperbara. Averiguar lascifras de glucorraquia al finalizar el bloqueo motor.PACIENTES Y MÉTODOS: Estudio prospectivo de 34pacientes bajo anestesia espinal continua con un catéter22 G, a través del cual se extraen muestras de líquidocefalorraquídeo para determinar la glucorraquia a los 5,10, 15, 20, 30, 45, 60 minutos y al final del bloqueomotor. Después de cada extracción se valora el grado delbloqueo motor y durante los primeros 20 minutos elnivel del bloqueo sensitivo.RESULTADOS: Se observa una tendencia descendente delos niveles de glucorraquia desde los 5 minutos (1027,07 ±349,04 mg dL-1), hasta el final del bloqueo motor completo(247,50 ± 20,39 mg dL-1). La probabilidad de no encontrarbloqueo motor con cifras de glucorraquia de 287,5 mgdL-1 o superiores es menor del 5%. Identificamos unacorrelación positiva entre el nivel más alto de bloqueo sensitivoy la duración del bloqueo motor completo (r = 0,62,p < 0,01) y entre las glucorraquias obtenidas en el momentodel nivel más alto de bloqueo sensitivo y al final del bloqueomotor completo (r = 0,50, p <0,01).CONCLUSIÓN: Después de una anestesia espinal continuacon bupivacaína hiperbara, la glucorraquia guardauna relación directa con el nivel más alto de bloqueosensitivo, la evolución y el final del bloqueo motor
OBJECTIVE: To study the relation between cerebrospinalfluid (CSF) glucose levels, the highest level of sensoryblock, and the duration of motor block after intrathecalinjection of 2 mL of hyperbaric bupivacaine. Todetermine CSF glucose levels upon recovery from motorblock.PATIENTS AND METHODS: A prospective study of 34patients administered a spinal anesthetic in continuousinfusion through a 22-gauge catheter. CSF samples wereextracted through the catheter 5, 10, 15, 20, 30, 45, and60 minutes after start of infusion and upon motor recovery.After each extraction the intensity of the motorblock was assessed; the intensity of the sensory blockwas assessed after each extraction up to 20 minutes.RESULTS: Glucose concentrations in CSF tended todecrease from 5 minutes (1027.07 [SD 349.04] mg dL-1)until full motor recovery (247.50 [20.39] mg dL-1). Theprobability not to find a motor block at a CSF glucoseconcentration of 287.5 mg dL-1 or higher was less than5%. We identified a positive correlation between the highestlevel of sensory block and the duration of full motorblock (r=0.62, P<0.01) and between CSF glucose levels atthe moment of greatest sensory block and upon fullmotor recovery (r=0.50, P<0.01).CONCLUSIONS: After continuous spinal anesthesia withhyperbaric bupivacaine, glucose concentrations in CSFare directly related to the highest level of sensory block,the course of the blockade, and its reversal
Subject(s)
Male , Female , Aged , Humans , Anesthesia, Spinal , Anesthetics, Local/pharmacokinetics , Bupivacaine/pharmacokinetics , Glucose/cerebrospinal fluid , Glucose Solution, Hypertonic/pharmacokinetics , Movement , Sensation , Prospective Studies , Anesthesia Recovery Period , Anesthetics, Local/administration & dosage , Bupivacaine/administration & dosage , Drug Interactions , Glucose Solution, Hypertonic/administration & dosage , Hydrogen Bonding , Injections, Spinal/methods , SolubilityABSTRACT
Between 1985-1989 were diagnosed 376 cases of TBC in "La Fe" hospital in Valencia. 36 of this cases also had AIDS. We have carried out a compared study among the 340 cases of TBC and the 36 cases of AIDS+TBC. In this way we have described the social and work conditions of both groups, the hospitalization, the associated pathologies, the different risk factors, the different characteristics of the disease in each group of TBC, the diagnoses methods and the treatment of each case.
