RESUMO
The aim of this study was to compare two equipotent solutions of hyperbaric bupivacaine and tetracaine in 30 elderly patients undergoing elective hip surgery under continuous spinal anaesthesia. With the patient in the supine position, 2 ml (8 mg) of either hyperbaric solution (density 1.030) were administered in a double-blind and randomized fashion. The median maximum sensory and temperature discrimination levels (T5 and T4) were similar with both solutions. The duration of analgesia was not different (114 +/- 23 min for bupivacaine and 125 +/- 35 min for tetracaine). Thirteen out of fifteen patients receiving bupivacaine and all 15 patients receiving tetracaine had complete motor blockade. The haemodynamic changes and vasopressor requirements were comparable. The plasma catecholamine levels measured at four different times remained unchanged and were not different between the two groups at any time. The authors conclude that, during continuous spinal anaesthesia, equipotent hyperbaric solutions of bupivacaine and tetracaine have similar anaesthetic and haemodynamic effects.
Assuntos
Raquianestesia , Bupivacaína , Tetracaína , Idoso , Idoso de 80 Anos ou mais , Raquianestesia/métodos , Pressão Sanguínea/efeitos dos fármacos , Bupivacaína/administração & dosagem , Bupivacaína/farmacologia , Método Duplo-Cego , Epinefrina/sangue , Feminino , Frequência Cardíaca/efeitos dos fármacos , Prótese de Quadril , Humanos , Masculino , Neurônios Motores/efeitos dos fármacos , Neurônios Motores/fisiologia , Bloqueio Nervoso , Neurônios Aferentes/efeitos dos fármacos , Neurônios Aferentes/fisiologia , Norepinefrina/sangue , Estimulação Física , Pressão , Temperatura , Tetracaína/administração & dosagem , Tetracaína/farmacologia , Fatores de TempoRESUMO
Variations of urethral pressure were registered with microtransducers in 427 gynecologic patients with lower urinary tract symptoms during urethrocystometry. Urethral instability (variation of urethral pressure greater than 15 cm of water) was found in 16.4% of patients. The comparison of the urinary symptoms and the urodynamic data between patients with urethral instability (without previous surgery for incontinence, N = 57), and patients with stable urethra (variation of urethral pressure less than 5 cm of water, N = 269) showed that urethral instability was related to frequency, nycturia, urgency, and a history of urethral syndrome. In 27% of patients, the urethral instability was associated with a bladder instability. The comparison between patients with urethral instability and stable bladder (N = 51) and patients with bladder instability and stable urethra (N = 41) revealed that bladder instability seems to be more important than urethral instability as a factor associated with nycturia, urgency, and urge incontinence.
